Knowledge and Practice in Emergency Obstetric and Neonatal Care (EmONC) Providers in Kinshasa, Democratic Republic of Congo

Abstract

Context: Maternal and newborn mortality remains a public health concern worldwide. Although its ratio decreased by around 44% from 1990 to 2015, this rate remains high in developing regions, particularly in sub-Saharan Africa. Objectives: To evaluate the level of knowledge and practice of Emergency Obstetric and Neonatal Care (EmONC) of health providers in maternity hospitals in Kinshasa and to identify the causes of the non-practice of EmONC. Methods: A descriptive study was conducted from September 1, 2016 to January 31, 2017 in 21 medical facilities drawn from the 6 health districts of the city of Kinshasa. We analyzed data obtained by interviewing 675 healthcare providers from different professional categories working in gynecology departments and in delivery rooms. The 50% acceptability criterion was set to assess their knowledge and practice. Results: Among the providers, 385 of them (57%) had already heard of EmONC and most of them were general practitioners with a rate of 55.8% of all participants, but specialists were the ones who defined them well. Supervision by trained colleagues was the main source of information on EmONC with 32.5%, while structured training only concerned 24% of our providers and 43% of providers had no training in EmONC. The level of knowledge was deemed satisfactory with 56.4% for the whole population but below the average for general practitioners. 32.2% of our sample did not practice the EmONC and the lack of training was the main reason for this non-practice. Conclusion: EmONC as a strategy in the fight against maternal mortality is not known. Its functions are known within the framework of basic training and current practice. Structured training only concerned 24% of our service providers and 43% of them had no training in EmONC.