Abstract
Pregnancy-related death is a cause for maternal and newborn mortality and morbidity as well as an obstacle for economic growth. Three-quarters of mothers' lives can be saved if women have access to a skilled health worker at delivery and emergency obstetric care. This evaluation was conducted to assess skilled delivery service implementation level by using three dimensions (availability, compliance, and acceptability) and identify major contributing issues for underutilization of the service. The evaluation design is cross-sectional. The study included 846 mothers who gave birth in Hadiya zone within one year prior to study period, using one year delivery records. Epi Info 3.5.3 and SPSS version 16 were employed for data analysis. Based on selected indicators, resource availability was inadequate for health facilities, human resource medical equipment, and rooms. On the compliance dimension, skilled delivery service coverage (34.8%), active management of third stage labor (32.7%), and health information at discharge and in postnatal care (PNC) visit (7.1%) critically complied with or poorly agreed to the guidelines and targets. Regarding skilled delivery service acceptability, welcoming, privacy keeping, reassurance during labor pain, follow-up, baby care, comfortability (rooms, beds, and clothing), cost of service, and episiotomy (without local anesthesia) were not acceptable.
Highlights
Skilled delivery service or care refers to the service provided to a woman and her newborn during pregnancy, childbirth, and immediately after birth by an accredited and competent health care provider who has at her/his disposal the necessary equipment and the support of a functioning health system, including transport and referral facilities for emergency obstetric care [2]
Study Area and Period. e study was conducted in Hadiya zone, which is located in southern Ethiopia, 230 km from Addis Ababa. is skilled delivery service program evaluation was conducted from April 1 to April 30 2014, by focusing on its process through a formative approach, by using dimensions, such as availability, compliance, and acceptability. e evaluation design was cross-sectional
A total of six kebeles, sampling frame was prepared for mothers who gave birth during the last year. e allocated sample size for urban and rural stratum was obtained using probability proportional allocation to the size (PPS) of mothers found in each selected kebeles
Summary
Process evaluation is an evaluation that assesses and describes program inputs activities and outputs in order to improve delivery service (e.g., identify obstacles and adjust activities) [1].Skilled delivery service or care refers to the service provided to a woman and her newborn during pregnancy, childbirth, and immediately after birth by an accredited and competent health care provider who has at her/his disposal the necessary equipment and the support of a functioning health system, including transport and referral facilities for emergency obstetric care [2].e deaths from the complications of pregnancy are estimated that 127 000 women (25%) die due to hemorrhage, 76 000 (15%) due to sepsis, 65 000 (12%) due to hypertensive disorders of pregnancy, 38 000 (8%) due to obstructed labor, and almost 67 000 (13%) due to abortion. Skilled delivery service or care refers to the service provided to a woman and her newborn during pregnancy, childbirth, and immediately after birth by an accredited and competent health care provider who has at her/his disposal the necessary equipment and the support of a functioning health system, including transport and referral facilities for emergency obstetric care [2]. Maternal deaths occur due to the same complications throughout the developing world, yet the technology to prevent them exists. 99% are in developing countries and a high proportion of these deaths occur in sub-Saharan Africa [3,4,5]. Every year at least 7 million women who survive childbirth suffer serious health problems and further 50 million women suffer adverse health consequences after childbirth such as anemia or reproductive tract infections or lifelong disabilities, such as obstetric fistulae [4, 5]
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