Quality of Intrapartum Care: Direct Observations in Selected Health Facilities in Zambia

Concepta N Kwaleyela,Margaret Connie Maimbolwa,Jeane Ngala Banda,Yolan Banda,Patricia Katowa-Mukwato,Brenda Nambala Sianchapa,Besia Phiri,Fabian Chapima,Victoria Mwiinga-Kalusopa,Emmanuel Mwila Musenge

doi:10.4236/health.2020.1211103

Concepta N Kwaleyela, Margaret Connie Maimbolwa + Show 8 more

Open Access

https://doi.org/10.4236/health.2020.1211103

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Journal: Health	Publication Date: Jan 1, 2020
Citations: 2	License type: CC BY 4.0

Affiliation: University of Zambia

Abstract

Approximately 303,000 women die annually while giving birth, worldwide, and more than 99% of the deaths occur in developing countries. In Zambia, a developing country situated in sub-Saharan Africa, most of the maternal mortalities occur during the intrapartum and immediate postpartum periods, arising from postpartum hemorrhage, sepsis, obstructed labor, and hypertensive disorders. Aim: The aim of this study was to assess the quality of intrapartum services provided in health facilities in the country. Methodology: Guided by a descriptive cross sectional design, data were collected from 264 women in labor using a World Health Organization validated observation checklist. Convenience sampling was used to recruit the women, while multistage sampling was used to select four health facilities. The Social Package for Social Sciences, version 23 was used to analyze the data. Results: One health facility met the World Health Organization 80% minimum standard in four out of the five categories used to measure quality in intrapartum care, while the other three met the minimum standard in one category each. Conclusion: Low numbers of midwives, inadequate supplies and equipment were major obstacles to following national and international agreed standards for providing optimal care during intrapartum period. Recommendations: There is need for local and national stakeholders in Zambia to urgently address the structural barriers that were observed, as well as invest in sufficient numbers of adequately trained and motivated midwives.

Highlights

Pregnancy and childbirth and their consequences are the leading causes of morbidity and mortality among women of the reproductive age
Comparing the results from the four health facilities that were in the study, Nangoma mission hospital met the World Health Organization (WHO) minimum standards of 80% in four out of the five categories that were used to measure quality in intrapartum care, while the other three health facilities met the standard in one category each
The conclusion of this study is that the quality of intrapartum care provided to women birthing in health facilities in Zambia was in most cases below the 80% WHO minimum standard for a facility to be considered to be offering quality labour and delivery services

Summary

Introduction

Pregnancy and childbirth and their consequences are the leading causes of morbidity and mortality among women of the reproductive age. In 2015, approximately 303,000 women died during pregnancy or while giving birth, worldwide, and more than 99% of the deaths occurred in developing countries [2]. Maternal mortality has remained to be a public health challenge in developing countries, in sub-Saharan Africa, where Zambia is situated. 303,000 women die annually while giving birth, worldwide, and more than 99% of the deaths occur in developing countries. In Zambia, a developing country situated in sub-Saharan Africa, most of the maternal mortalities occur during the intrapartum and immediate postpartum periods, arising from postpartum hemorrhage, sepsis, obstructed labor, and hypertensive disorders. Results: One health facility met the World Health Organization 80% minimum standard in four out of the five categories used to measure quality in intrapartum care, while the other three met the minimum standard in one category each.

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