Abstract
BackgroundHealthcare service delivery systems need to ensure standard quality of care (QoC) for achieving expected health outcomes. Although Bangladesh has a good healthcare service delivery system, there are major concerns about the quality of maternal and newborn health (MNH) care services, which is imperative for achievements in health. The study aimed to measure the QoC for different MNH services in two selected public health facilities of Bangladesh. This study also documented the specific areas of each care which needs intervention.MethodsThe study was conducted in two district-level public health facilities—a district hospital (DH) and a mother and child welfare centre (MCWC). A total of 228 cases of MNH services were observed by using contextualized checklist ‘Standards-based Management and Recognition (S-BMR)’ for 8 selected MNH care services. For scoring, performed activities were calculated as percentages of the total recommended activities and categorized as high (> 80%), moderate (50 to 80%), and low (< 50%).ResultsOverall QoC scores were moderate for each DH (54.8%), and MCWC (56.1%). In DH, the QoC score was high for blood transfusion (80.3%); moderate for maternal complications management (77.0%), caesarean section (CS) (65.6%), infection prevention (64.3%), sick newborn care (54.1%), and normal vaginal delivery (NVD) (52.6%); and low for antenatal care (ANC) (25.6%) and postnatal care (PNC) (19.0%). In MCWC, the QoC scores were high for infection prevention (83.0%); moderate for CS (76.5%) and NVD (59.8%); and low for ANC (36.9%) and PNC (24.5%).ConclusionsIn the study facilities, the QoC for MNH services is found to be unsatisfactory, particularly for ANC and PNC. Urgent initiative needs to be taken by introducing contextualized quality monitoring tools at health facilities, along with training of the care providers and introducing a quality monitoring system.
Highlights
Healthcare service delivery systems need to ensure standard quality of care (QoC) for achieving expected health outcomes
Surgical care was provided by the obstetrician or trained medical doctors but normal vaginal delivery (NVD) along with antenatal care (ANC) and postnatal care (PNC) were mostly conducted by the nurses at district hospital (DH) and family welfare visitors (FWVs) in mother and child welfare centre (MCWC)
Overall QoC for maternal and newborn health (MNH) services were moderate in both DH and MCWC by yielding scores of 55 and 56% respectively
Summary
Healthcare service delivery systems need to ensure standard quality of care (QoC) for achieving expected health outcomes. Bangladesh has a good healthcare service delivery system, there are major concerns about the quality of maternal and newborn health (MNH) care services, which is imperative for achievements in health. Though both the directorates are under the Ministry of Health and Family Welfare, the human resources structure and management systems are different in DHs and MCWCs. most of the DHs have more or less the same human resources, infrastructures, drugs, equipment and service provisions. The district level MCWCs are similar in terms of health system readiness and services Both types of facilities are referral hospitals and usually receive patients from sub-district and below levels of the health system [8].
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