Quality of Normal Delivery Care in Côte d'Ivoire

Thérèse, Delvaux; Odile, Aké-Tano; Valérie, Gohou-Kouassi; Patrice, Bosso; Simon, Collin; Ronsmans, Carine

doi:10.2307/30032485

Cited by 25 publications

(14 citation statements)

References 17 publications

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“…In this study only 31.25% of the facilities fulfilled the quality standards for delivery services according to the national guidelines, which comparable to reports from other Sub-Saharan Africa countries [12, 13, 21]. The poor performance of health facilities on process quality has serious implications on the efficiency of the care provided in the health facilities, leading to delayed treatment that in turn negatively affect the outcome of birth leading to either fetal/newborn or maternal death [20].…”

Section: Discussionsupporting

confidence: 83%

Quality of the delivery services in health facilities in Northern Ethiopia

Fisseha

Berhane

Worku

et al. 2017

BMC Health Serv Res

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BackgroundSubstantial improvements have been observed in the coverage of and access to maternal health service, especially in skilled birth attendants, in Ethiopia. However, the quality of care has been lagging behind. Therefore, this study investigated the status of the quality of delivery services in Northern Ethiopia.MethodsA facility based survey was conducted from December 2014 to February 2015 in Northern Ethiopia. The quality of delivery service was assessed in 32 health facilities using a facility audit checklist, by reviewing delivery, by conducting in-depth interview and observation, and by conducting exit interviews with eligible mothers. Facilities were considered as ‘good quality’ if they scored positively on 75% of the quality indicators set in the national guidelines for all the three components; input (materials, infrastructure, and human resource), process (adherence to standard care procedures during intrapartum and immediate postpartum periods) and output (the mothers’ satisfaction and utilization of lifesaving procedures).ResultsOverall 2 of 32 (6.3%) of the study facilities fulfilled all the three quality components; input, process and output. Two of the three components were assessed as good in 11 of the 32 (34.4%) health facilities. The input quality was the better of the other quality components; which was good in 21 out of the 32 (65.6%) health facilities. The process and output quality was good in only 10 of the 32 (31.3%) facilities.ConclusionsOnly 6.3% of the studied health facilities had good quality in all three dimensions of quality measures that was done in accordance to the national delivery service guidelines. The most compromised quality component was the process. Systematic and sustained efforts need to be strengthened to improve all dimensions of quality in order to achieve the desired quality of delivery services and increase the proportion of births occurring in health facilities.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2125-3) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 83%

Quality of the delivery services in health facilities in Northern Ethiopia

Fisseha

Berhane

Worku

et al. 2017

BMC Health Serv Res

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“…In 1.5% to 46.5% of cases, when the action line was crossed, partograph findings did not translate into action. It is possible that these were completed after the delivery, a practice that has been reported in the literature [28,29]. However, we cannot corroborate this from our data.…”

Section: Discussionmentioning

confidence: 53%

Assessing the quality of record keeping for cesarean deliveries: results from a multicenter retrospective record review in five low-income countries

Landry

Pett

Fiorentino

et al. 2014

BMC Pregnancy Childbirth

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BackgroundReliable, timely information is the foundation of decision making for functioning health systems; the quality of decision making rests on quality data. Routine monitoring, reporting, and review of cesarean section (CS) indications, decision-to-delivery intervals, and partograph use are important elements of quality improvement for maternity services.MethodsIn 2009 and 2010, a sample of CS records from calendar year 2008 was reviewed at nine facilities in Bangladesh, Guinea, Mali, Niger, and Uganda. Data from patient records and hospital registers were collected on key aspects of care such as timing of key events, indications, partograph use, maternal and fetal outcomes. Qualitative interviews were conducted with key informants at all study sites to provide contextual background about CS services and record keeping practices.ResultsA total of 2,941 records were reviewed and 57 key informant interviews were conducted. Patient record-keeping systems were of varying quality across study sites: at five sites, more than 20% of records could not be located. Across all sites, patient files were missing key aspects of CS care: timing of key events (e.g., examination, decision to perform CS), administration of prophylactic antibiotics, maternal complications, and maternal and fetal outcomes. Rates of partograph use were low at six sites: 0 to 23.9% of patient files at these sites had a completed partograph on file, and among those found, 2.1% to 65.1% were completed correctly. Information on fetal outcomes was missing in up to 40% of patient files.ConclusionsDeficits in the quality of CS patient records across a broad range of health facilities in low-resource settings in four sub-Saharan Africa countries and Bangladesh indicate an urgent need to improve record keeping.

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“…Training during pregnancy for women and their families to recognise prolonged labour is part of fistula prevention programmes [48, 49], with the potential to promote partograph use. An important factor reported as limiting partograph use was admission late in labour [26, 38, 47, 50–52]. Clearly, some women who present later in labour may be progressing well, but others may be experiencing complications that could have been be prevented by earlier partograph monitoring .…”

Section: Resultsmentioning

confidence: 99%

“…Once established, supervision and monitoring [1, 15, 42, 58], and audit and evaluation [1, 16, 56, 59, 60], were important to the maintenance of partograph use and quality. Without them, some social contexts allowed poor practice such as the acceptance of retrospective documentation, with completion of partographs after delivery and before discharge particularly well-described [16, 35, 38, 47, 50, 57]. Contexts lacking a culture of evidence-based practice [47], or monitoring [50, 61, 62], were also barriers to partograph use.…”

Section: Resultsmentioning

confidence: 99%

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Barriers to and incentives for achieving partograph use in obstetric practice in low- and middle-income countries: a systematic review

Ollerhead¹,

Osrin²

2014

BMC Pregnancy Childbirth

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BackgroundThe partograph is a graphic display of the progress of labour, recommended by the World Health Organization, but often underused in practice in low- and middle-income countries. We were interested in going beyond demonstration of potential efficacy – on which the existing literature concentrates - through a systematic review to identify barriers to and incentives for achieving partograph use.MethodsWe searched Ovid MEDLINE, Ovid Maternity and Infant Care, POPLINE, Web of Science, and Scopus, from 1st January 1994 to 30th September 2013, using the term ‘partogra*’ to include ‘partograph’, ‘partogram’, or ‘partogramme’. The selection criteria were for primary or secondary research describing barriers to and incentives for partograph use in low- and middle-income countries, in English, reported in peer-reviewed publications since 1994. Thematic analysis of text on partograph use was applied to a commonly used framework for change in clinical practice, with levels describing the innovation, the individual professional, the woman, and social, organisational, economic and political contexts.ResultsReported barriers to and incentives for partograph use related to the partograph itself, professional skills and practice, clinical leadership and quality assurance, and the organisational environment within the wider provision of obstetric care. Neither the evidence base for its effectiveness, nor its credibility, was reported as a barrier to use.ConclusionIdentifying and addressing local barriers and incentives in low- and middle-income countries, based on those in published research, could inform strategies to improve partograph use. Emerging technologies could be used to address some barriers. The thresholds for essential maternity care at which the partograph adds value should be further evaluated.

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Quality of Normal Delivery Care in Côte d'Ivoire

Cited by 25 publications

References 17 publications

Quality of the delivery services in health facilities in Northern Ethiopia

Quality of the delivery services in health facilities in Northern Ethiopia

Assessing the quality of record keeping for cesarean deliveries: results from a multicenter retrospective record review in five low-income countries

Barriers to and incentives for achieving partograph use in obstetric practice in low- and middle-income countries: a systematic review

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