Midwife-led continuity of care improved maternal and neonatal health outcomes in north Shoa zone, Amhara regional state, Ethiopia: A quasi-experimental study

Hailemeskel, Solomon; Alemu, Kassahun; Christensson, Kyllike; Tesfahun, Esubalew; Lindgren, Helena

doi:10.1016/j.wombi.2021.08.008

Cited by 8 publications

(9 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Afterward, we conducted a comprehensive assessment of 651 articles based on their full-text content. Ultimately, a total of 13 articles met the inclusion criteria ( 27 – 39 ). The PRISMA flow diagram outlines the stages of theme selection and provides the rationale for exclusions (see Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

Improving the quality of neonatal health care in Ethiopia: a systematic review

Belay,

Erku,

Bayih

et al. 2024

Front. Med.

View full text Add to dashboard Cite

BackgroundEnsuring high-quality healthcare for newborns is essential for improving their chances of survival within Ethiopia's healthcare system. Although various intervention approaches have been implemented, neonatal mortality rates remain stable. Therefore, the present review seeks to identify initiatives for enhancing healthcare quality, their effects on neonatal wellbeing, and the factors hindering or supporting these Quality Improvement (QI) efforts' success in Ethiopia.MethodsWe searched for original research studies up to June 23, 2023, using PubMed/Medline, WHO-Global Health Library, Cochrane, Clinical Trials.gov, and Hinari. After selecting eligible studies, we assessed their quality using a mixed-method appraisal tool. Quality of care refers to how healthcare services effectively improve desired outcomes for individuals and patient populations. It encompasses vital principles such as safety, effectiveness, timeliness, efficiency, equity, and patient-centeredness.ResultsWe found 3,027 publication records and included 13 studies during our search. All these interventions primarily aimed to provide safe healthcare, with a strong focus on Domain One, which deals with the evidence-based routine upkeep and handling of complications, and Domain Seven, which revolves around ensuring staff competency, emerged as a frequent target for intervention. Many interventions aimed at improving quality also concentrate on essential quality measure elements such as processes, focusing on the activities that occur during care delivery, and quality planning, involving distributing resources, such as basic medicine and equipment, and improving infrastructure. Moreover, little about the facilitators and barriers to QI interventions is investigated.ConclusionsThis review highlights the significance of introducing QI initiatives in Ethiopia, enhancing the healthcare system's capabilities, engaging the community, offering financial incentives, and leveraging mobile health technologies. Implementing QI interventions in Ethiopia poses difficulties due to resource constraints, insufficient infrastructure, and medical equipment and supplies shortages. It necessitates persistent endeavors to improve neonatal care quality, involving ongoing training, infrastructure enhancement, the establishment of standardized protocols, and continuous outcome monitoring. These efforts are crucial to achieving the optimal outcomes for newborns and their families.

show abstract

Section: Resultsmentioning

confidence: 99%

Improving the quality of neonatal health care in Ethiopia: a systematic review

Belay,

Erku,

Bayih

et al. 2024

Front. Med.

View full text Add to dashboard Cite

show abstract

“…Well-managed debriefs that allow self-reflection may assist midwives in communicating news to the mother that her baby has died [ 63 , 64 ]. Additionally, midwife-led continuity of care has shown promise in Ethiopia, improving maternal and neonatal outcomes during antenatal, labour and birth [ 65 ]. Based on the literature and the findings of this study, resilience can be defined in terms of adaptation to difficult ongoing challenges and traumatic events with mental, emotional, and behavioural elasticity [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Silent Tears of Midwives: ‘I Want Every Mother Who Gives Birth to Have Her Baby Alive’—A Narrative Inquiry of Midwives Experiences of Very Early Neonatal Death from Tanzania

Becker¹,

Becker²,

Abeysekera

et al. 2023

Children

View full text Add to dashboard Cite

Background: Midwives working in settings with limited clinical resources experience high rates of very early neonatal deaths. Midwives manage the impact of this grief and trauma almost daily, which may affect patient care and their own well-being. Research Aims: To explore how midwives are impacted by and cope with high rates of very early neonatal deaths. To document midwives’ insights and local solutions that may reduce very early neonatal deaths in limited resource settings. To document the stories of midwives in order to create awareness and garner support for midwives and their critical work in low resource settings. Methods: Narrative inquiry utilizing semi structured interviews. Twenty-one midwives with at least six months experience who had experienced or witnessed very early neonatal death were interviewed. Data were audio recorded and transcribed, and reflexive thematic analysis of transcripts was conducted. Results and Discussion: Three themes were identified: (1) deep sadness resulting from very early neonatal deaths leading to internal struggles; (2) use of spirituality, including prayer and occasional beliefs that unexplainable deaths were ‘God’s plan’; and (3) development of resilience by seeking solutions, educating themselves, taking accountability and guiding mothers. Participating midwives noted that inadequate staff and high caseloads with limited basic supplies hindered their clinical practice. Participants articulated that they concentrated on active solutions to save babies during labour, such as vigilant foetal rate heart monitoring and partogram. Further, reduction and prevention of very early neonatal death is a complex problem requiring multidisciplinary teams and woman-centred care approaches to address issues contributing to the health of mothers and their new-borns. Conclusions: Midwives’ narratives highlighted ways of coping with grief and deep sadness, through prayer, and further education of both mothers and fellow colleagues to achieve better antenatal and intrapartum care and outcomes. This study gave midwives an opportunity for their voices to be heard and to generate solutions or insights that can be shared with colleagues in similar low-resource settings.

show abstract

“…Models of care included a lead midwife delivering care across the continuum [59,60], midwives on-call for women during labour who they had previously seen for antenatal care [61], and a midwifery continuity of care team that ran in parallel with an obstetric team [62]. An initiative in Ethiopia involved the same midwife providing antenatal, intrapartum and postnatal care to the same women [63,64]. An initiative in Kenya involved midwifery care across the childbearing continuum, embedded within a family planning and HIV care service [65].…”

Section: 'The How': Describing the Way Continuity Of Care Is Providedmentioning

confidence: 99%

“…Similar to HICs, continuity of care services were located as part of the usual hospital services (eg in Pakistan [59,72], China [61], Ethiopia [63,64], Palestine [67][68][69] or in community health centres or maternity clinics, for example in Bangladesh [60,70], Kenya [65] and Afghanistan [73]. Most services were based in urban or semi-urban areas but there were some examples from rural areas, for example, Palestine [67][68][69], Bangladesh [70], Afghanistan [73] and Indonesia [74].…”

Section: 'The How': Describing the Way Continuity Of Care Is Providedmentioning

confidence: 99%

See 1 more Smart Citation

Midwifery continuity of care: A scoping review of where, how, by whom and for whom?

Bradford

Wilson

Portela

et al. 2022

PLOS Glob Public Health

View full text Add to dashboard Cite

Systems of care that provide midwifery care and services through a continuity of care model have positive health outcomes for women and newborns. We conducted a scoping review to understand the global implementation of these models, asking the questions: where, how, by whom and for whom are midwifery continuity of care models implemented? Using a scoping review framework, we searched electronic and grey literature databases for reports in any language between January 2012 and January 2022, which described current and recent trials, implementation or scaling-up of midwifery continuity of care studies or initiatives in high-, middle- and low-income countries. After screening, 175 reports were included, the majority (157, 90%) from high-income countries (HICs) and fewer (18, 10%) from low- to middle-income countries (LMICs). There were 163 unique studies including eight (4.9%) randomised or quasi-randomised trials, 58 (38.5%) qualitative, 53 (32.7%) quantitative (cohort, cross sectional, descriptive, observational), 31 (19.0%) survey studies, and three (1.9%) health economics analyses. There were 10 practice-based accounts that did not include research. Midwives led almost all continuity of care models. In HICs, the most dominant model was where small groups of midwives provided care for designated women, across the antenatal, childbirth and postnatal care continuum. This was mostly known as caseload midwifery or midwifery group practice. There was more diversity of models in low- to middle-income countries. Of the 175 initiatives described, 31 (18%) were implemented for women, newborns and families from priority or vulnerable communities. With the exception of New Zealand, no countries have managed to scale-up continuity of midwifery care at a national level. Further implementation studies are needed to support countries planning to transition to midwifery continuity of care models in all countries to determine optimal model types and strategies to achieve sustainable scale-up at a national level.

show abstract

Midwife-led continuity of care improved maternal and neonatal health outcomes in north Shoa zone, Amhara regional state, Ethiopia: A quasi-experimental study

Cited by 8 publications

References 28 publications

Improving the quality of neonatal health care in Ethiopia: a systematic review

Improving the quality of neonatal health care in Ethiopia: a systematic review

Silent Tears of Midwives: ‘I Want Every Mother Who Gives Birth to Have Her Baby Alive’—A Narrative Inquiry of Midwives Experiences of Very Early Neonatal Death from Tanzania

Midwifery continuity of care: A scoping review of where, how, by whom and for whom?

Contact Info

Product

Resources

About