Readiness of public health facilities to provide quality maternal and newborn care across the state of Bihar, India: a cross-sectional study of district hospitals and primary health centres

Abstract

IntroductionPoor access to quality healthcare is one of the most important reasons of high maternal and neonatal mortality in India, particularly in poorer states like Bihar. India has implemented initiatives to promote institutional maternal deliveries. It is important to ensure that health facilities are adequately equipped and staffed to provide quality care for mothers and newborns.MethodsWe conducted a cross-sectional study of 190 primary health centres (PHCs) and 36 district hospitals (DHs) across all districts in Bihar to assess the readiness of facilities to provide quality maternal and neonatal care. Infrastructure, equipment and supplies and staffing were assessed using the WHO service availability and readiness assessment and Indian public health standard guidelines. Additionally, we used household survey data to assess the quality of care reported by mothers delivering at study facilities.ResultsPHCs and DHs were found to have 61% and 67% of the mandated structural components to provide maternal and neonatal care, on average, respectively. DHs were, on average, slightly better equipped in terms of infrastructure, equipment and supplies by comparison to PHCs. DHs were found to be inadequately prepared to provide neonatal care. Lack of recommended handwashing stations and bins at both DHs and PHCs suggested low levels of hygiene. Only half of the essential drugs were available in both DHs and PHCs. While no association was revealed between structural capacity and patient-reported quality of care, adequacy of staffing was positively associated with the quality of care in DHs.ConclusionExamining all DHs and a representative sample of PHCs in Bihar, this study revealed the gaps in structural components that need to be filled to provide quality care to mothers and newborns. Access to quality care is essential if progress in reducing maternal and neonatal mortality is to be achieved in this high-burden state.

Women’s customer trusts in hospital's inpatient services

“…Furthermore, efforts to accelerate the reduction of maternal mortality can be done by ensuring that every mother can access the qualified health services such as maternal health services, delivery assistance by trained health personnel, post-partum services for mothers and infants, special care and referral in case of complications, ease of getting maternity leave and childbirth, and family planning service. 15 Women's customer trust in government-provided facilities especially for pregnant and mothers is expected to help the birth of a golden generation that will improve the health and quality of life of Indonesians.…”

How to Estimate Optimal Malaria Readiness Indicators at Health-District Level: Findings from the Burkina Faso Service Availability and Readiness Assessment (SARA) Data

“…A descriptive analysis was applied to the data to provide regionally and nationally representative estimates; this allowed the percentage of facilities providing specific services with tracer items or owning the equipment on the day of the assessment to be estimated. Beyond these descriptive statistics, health facility readiness indicators are also increasingly being used in SSA countries to assess the health system strengthening through the construction of a composite score [33][34][35]. In some studies, either principal component analysis (PCA) [36][37][38][39] or multiple correspondences analysis (MCA) [40,41] was directly applied to readiness indicators, which are usually defined as binary variables [8,16,40].…”

Successes, Challenges and Opportunities Towards Universal Health Coverage for Maternal and Child Health in South East Asian Countries: A Systematic Review

“…When considering the quality of MCH care, facility readiness was detected as poor for emergency obstetric care and newborn care in public and private health facilities including primary care facilities both rural and urban areas in India, Nepal and Bangladesh 21,31,47,56 . Several studies detected inadequate infrastructure leads to poor quality in maternal and child care including family planning services in the region 12,[22][23][24]26,28,38,45,51,52,56,60,65,73 . In addition to those problems, irregular supply of water and electricity, lessfunctioning of blood bank 12 , inadequate laboratory facilities 12,56,61 were detected as challenges.…”

“…Inadequate healthcare workers including specialists was identi ed as a challenge for provision of better maternal and neonatal care in India, Nepal, Bangladesh, Indonesia, Timor-Leste and Myanmar 12,22,24,26,29,8,45,47,49,51,56,61,63,69,73 . Shortage of staff is widespread in rural areas.…”