Abstract
Negative experiences of care may act as a deterrent to current and/or future utilization of facility-based health services. To examine the situation in Tanzania, we conducted a sub-analysis of a cross-sectional household survey conducted in April 2016 in the Mara and Kagera regions of Tanzania. The sample included 732 women aged 15–49 years who had given birth in a health facility during the previous two years. Log binomial regression models were used to investigate the association between women’s experiences of care during childbirth and the receipt of early postnatal checks before discharge. Overall, 73.1% of women reported disrespect and abuse, 60.1% were offered a birth companion, 29.1% had a choice of birth position, and 85.5% rated facility cleanliness as good. About half of mothers (46.3%) and newborns (51.4%) received early postnatal checks before discharge. Early postnatal checks for both mothers and newborns were associated with no disrespect and abuse (RR: 1.23 and 1.14, respectively) and facility cleanliness (RR: 1.29 and 1.54, respectively). Early postnatal checks for mothers were also associated with choice of birth position (RR: 1.18). The results suggest that a missed opportunity in providing an early postnatal check is an indication of poor quality of the continuum of care for mothers and newborns. Improved quality of care at one stage can predict better care in subsequent stages.
Highlights
Maternal and neonatal mortality remains high in Tanzania: 556 maternal deaths per 100,000 live birth were recorded by the 2015–2016 Tanzania Demographic and Health Survey and Malaria IndicatorSurvey (TDHS-MIS) compared with 454 maternal deaths per 100,000 live births recorded by the 2010TDHS [1]
This study explored women’s experience of facility-based childbirth care in the two regions, including disrespect and abuse, choice of birth position, offer of a birth companion, and perceived facility cleanliness
This study examined two different dimensions of the quality of care at health facilities in two regions of the Lake Zone of Tanzania: first, women’s experiences of care during labor and delivery and, second, coverage of early postnatal checks before women and newborns are discharged
Summary
Maternal and neonatal mortality remains high in Tanzania: 556 maternal deaths per 100,000 live birth were recorded by the 2015–2016 Tanzania Demographic and Health Survey and Malaria IndicatorSurvey (TDHS-MIS) compared with 454 maternal deaths per 100,000 live births recorded by the 2010TDHS [1]. Maternal and neonatal mortality remains high in Tanzania: 556 maternal deaths per 100,000 live birth were recorded by the 2015–2016 Tanzania Demographic and Health Survey and Malaria Indicator. Survey (TDHS-MIS) compared with 454 maternal deaths per 100,000 live births recorded by the 2010. Neonatal mortality is high, at 25 per 1000 live births [1]. Efforts to reduce maternal and newborn morbidity and mortality have emphasized increasing facility-based childbirths with skilled attendants [2]. The increase in facility deliveries has not been matched by an anticipated decrease in maternal and newborn deaths. Poor quality of care during childbirth in health facilities, not least in the continuum of care, is probably the most important factor to explain the discrepancy between the observed high coverage of institutional deliveries and stubbornly high maternal and perinatal mortality rates [5]
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