Abstract
BackgroundBetter quality of care around the time of childbirth can significantly improve maternal and newborn survival. In countries like India, where the private sector contributes to a considerable proportion of institutional deliveries, it is important to assess the quality of maternity care offered by private sector healthcare facilities. This study seeks to fill that information gap by analysing baseline assessments conducted for the Manyata program, which aims to improve the quality of maternity care at private facilities.MethodsAn observation checklist based on 16 clinical standards endorsed by the Federation of Obstetric and Gynaecological Societies of India (FOGSI) was used to assess 201 private sector healthcare facilities in Maharashtra, Jharkhand, and Uttar Pradesh. Data on facility characteristics came from profiles completed when facilities enrolled in Manyata. Differences in the mean number of standards met were analysed by facility characteristics and the availability of essential supplies.ResultsAround half (47.1%) of all nursing staff engaged in maternity care services at these private healthcare facilities were under qualified. The mean number of clinical standards met by facilities was 3.2 (SD 2.4). Facilities with a monthly delivery load between 20 and 50 met a significantly higher number of standards, as did facilities that had more than 70% of essential supplies available. Both these factors were also significant in a multiple linear regression analysis.ConclusionsThe overall quality of maternity care in private healthcare facilities is poor in all three states, especially for clinical standards related to management of complications.
Highlights
Better quality of care around the time of childbirth can significantly improve maternal and newborn survival
The private sector contributes to a considerable proportion of institutional deliveries across the world [13] and plays an important role in delivering health care services in India, providing 80% of all outpatient care and up to 60% of inpatient care
The criteria for including private healthcare facilities in the Manyata program are that the facility: 1) is registered with local health authorities, 2) provides maternity services, 3) has an owner or in-charge who is a member of FOGSI, and 4) expresses willingness to participate in the Manyata program by paying a nominal fee and submitting letter of intent to FOGSI
Summary
Better quality of care around the time of childbirth can significantly improve maternal and newborn survival. In the context of Sustainable Development Goal 3 [10], it is essential to focus on the provision of high quality care during childbirth to reduce adverse maternal and neonatal outcomes [11, 12]. This requires a focus on private as well as public sector healthcare facilities. The private sector contributes to a considerable proportion of institutional deliveries across the world [13] and plays an important role in delivering health care services in India, providing 80% of all outpatient care and up to 60% of inpatient care. According to the National Family Health Survey 4 (NFHS-4), the private sector accounts for up to 22% of institutional deliveries in rural areas and up to 43% of institutional deliveries in urban areas [15]
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