Evidence based obstetric and newborn practice is poor in Northern Ethiopia

Background: Improving maternal and neonatal health remain the most elusive of the Millennium Development Goals. Improving quality of obstetric care is one of the strategies in Health sector development program IV (HSDP IV) of... [ view full abstract ]

Background: Improving maternal and neonatal health remain the most elusive of the Millennium Development Goals. Improving quality of obstetric care is one of the strategies in Health sector development program IV (HSDP IV) of Ethiopia. It is aimed to deliver quality health services as central for improving the health status of the population. In addition, satisfying patients and clients is the primary goal of the Government’s reform program. Therefore, the aim of study was to assess quality obstetric service in Northern Ethiopia.
Methods: A mix of methods of facility survey was employed using both quantitative and qualitative method of data collection from December 2014 to February, 2015 in Northern Ethiopia. The study subjects were health facilities, skilled birth attendants, laboring mother, postpartum mother and registers at facilities. For health facility survey, 32 health facilities, all skilled birth attendants and 216 laboring mothers for observation, exit-interview and charts review were included. Data were collected using observation, facility audit, face to face and in-depth interview, and document reviews. Standardized questionnaire and checklist was developed to collect data. Data were analyzed by STATA version 12.0. Descriptive analysis of data was performed and data were weighted using principal component analysis.
Result: The response rate for this study for both the observation of childbirth and exit interview was 100% (216). Quality obstetric and newborn care accounts for more than half of births (53%) and (55%) respectively. Most mothers got quality obstetric care during first-stage of labour. About 57% of births experienced non-beneficiary obstetric practice and some were inappropriate practice. Rate of episiotomy was high and birth companion was not allowed in one fourth of births. Emergency obstetric care utilization among health facilities were poor (53%). More than half (59%) of health facilities had poor structural quality service, not read for delivery service.
Conclusion: overall there is poor quality obstetric and newborn service in terms of the three components input, process and output. This indicates the needs for more improvement to obstetric and newborn service for early preparedness to prevent and control of complications to mothers and newborns during childbirths and to make the facility more attractive so that the mother can use childbirth service in future and to achieve the intended strategies.
Keyword: Evidence based, Quality obstetric, newborn care, health facility preparedness, EmOC, Ethiopia