Kaveri Mayra
Oxford Policy Management Ltd.
Kaveri Mayra is National Manager for Quality of Care Evaluation. She is trained in nursing and public health and is managing an evaluation to understanding the quality of care and Nurse Mentoring in India. Her research interests include different issues and challenges of nursing workforce, Gender and respectful maternity care.
Background- Providing respectful maternity care is a key strategy for reducing global maternal mortality. To date, efforts to understand mistreatment have relied heavily on clients’ self-report. Mistreatment may be normalized and not regarded as such by clients, other approaches for data collection are needed to identify these. Direct observation of delivery (DOD) tools provides an alternative, standardized approach to documenting mistreatment. DOD quantitative items, however, cannot capture the full context of a birth experience. Qualitative data, collected simultaneously during a DOD, have the potential to provide valuable context about intrapartum care provision and inform quality of care assessments and DOD tools.
Objective- Identify and synthesize qualitative comments about mistreatment collected during DOD.
Methods- We used thematic analysis to synthesize 1158 qualitative comments from 547 DODs in 225 facilities representing all the 38 districts of Bihar. Trained nurse observers documented intrapartum behaviors from triage to a woman’s discharge. A coding structure was developed with two researchers and then applied to then entire data set. Comments were categorized into themes.
Results- Analysis is ongoing. Preliminary analysis from the first 161DODs suggest themes around non-evidence based practices for both maternal and new-born care, verbal and physical abuse, poor infection control & waste management practices, misuse of human resources, and poor patient communication and support and misreporting of care provided. A final analysis will be complete in May 2017.
Discussion and Conclusion-Qualitative comments collected during DOD provide valuable context for poor quality of care and guides future training and research initiatives. Specifically, appropriate task-shifting and infection control practices should be a focus of future capacity building for front-line healthcare workers in Bihar.
Preferred Presentation Mode: Oral or Symposium
Studies of collaboration to improve maternal, infant, family, and maternity staff wellbein
