Quality of intrapartum care at health centres of West Gojjam Zone, Amhara Region, Ethiopia

Abstract

Introduction: Ethiopia is among the top five materal mortality contributors and has high newborn mortality rate and the provision of quality intrapartum care at primary health care units of health centres could reduce maternal and newborn death. Purpose: the purpose of the study was to assess the quality of intrapartum care, providers’ practise of respectful maternity care and clients’ satisfaction with intrapartum care at selected rural health centres and to develop strategies to improve the quality of intrapartum care at health centre level. Method: the researcher selected a convergent parallel mixed methods research design for the study. Twenty-six health centres, 279 labour and delivery clients and 247 post natal women were enrolled to participate. The study was conducted in five strands, namely three quantitative, one qualitative, and a Delphi technique to reach consensus on the strategies developed for quality intrapartum care improvement at health centre level. Result: the study found a 74% overall quality of intrapartum care service provision, 81.4% availability of medical equipment and supplies, and 66.5% quality intrapartum care competency and respectful maternity care, and 74.5% client satisfaction. Challenges included poor cleanliness of labour and delivery rooms and beds; shortage of water; shortage of incinerators; unsafe waste disposal; shortages of equipment, supplies, and drugs; inadequate staffing; inadequate utilisation of partographs; lack of technical competency, and a loose referral system and feedback. Strategy development: Based on the findings, the researcher developed strategies to improve quality intrapartum care service at health centre level. Finally, a Delphi panel of experts reached consensus on the final strategies.