Quality Maternal Health Research Articles

Evaluation of Quality of Maternal Health Services in Selected Primary Health Centers in Rivers State

The quality of care a woman experience during the prenatal, intrapartum and postpartum period has a direct impact on her health and the health of her child, and it might also affect her decision to seek care in the future. This study evaluated the quality of maternal health services in selected primary health centers in Rivers State. The study design was cross-sectional study design. Multistage sampling was used to select seven Primary health centers (PHCs) while simple random sampling was used to select 384 post-natal mothers across the selected PHCs. Self-administered questionnaire and checklist were used to assess the postnatal mothers and primary health centers respectively. The questionnaire collected data on socio-demographic variables, levels of satisfaction and factors influencing the quality of maternal health services while the checklist collected data on the extent to which the facilities have the capacity to support quality maternal health services. Three hundred and forty-one questionnaires and the entire checklist used for the survey were retrieved. SPSS V22 was used in the analytical process and data was analyzed using descriptive statistics. Results revealed that 40.2% of the postnatal mothers were within age 26-33 years, 54.8% had secondary school as their highest educational level and 85% were married. Majority of the mothers were satisfied with the maternal healthcare services in PHCs in Rivers State, mean was 102.24±11.68; the perceived factors influencing the quality of maternal health services in PHCs in Rivers State include, healthcare delivery (96.2%), adequate human and material resources (94.1%), staff conduct and practice (86.2%) and physical facilities (84.5%); although PHCs with facilities that are available and in good condition were 85.7% they are not fully equipped to support quality basic obstetric emergency care.

Health facilities preparedness to deliver maternal and newborn health care in Kilifi and Kisii Counties, Kenya

IntroductionHealth facility preparedness is essential for delivering quality maternal and newborn care, minimizing morbidity and mortality by addressing delays in seeking skilled care, reaching appropriate facilities, and receiving emergency care. A rapid assessment of 23 government health facilities in Kilifi and Kisii counties identified poor maternal and newborn indicators in 16 facilities. The Access to Quality Care through Extending and Strengthening Health Systems (AQCESS) project supported these facilities with training, equipment, and referral linkages. This study focuses on facility preparedness of the 16 facilities to deliver maternal and newborn health services, specifically delays two and three at the end of the project implementation.MethodsA descriptive cross-sectional study was carried-out on behalf of AQCESS project team by respective county ministry of health in-charge of reproductive maternal newborn and child health programs and trained nurses and medical doctors from Aga Khan health services in December 2019. The study evaluated the accessibility and reliability of drugs, commodities, equipment, personnel, basic necessities (such as water and electricity), and guidelines using validated World Health Organization service availability and readiness assessment tool. The findings of the assessment are presented through frequency and percentage analysis, along with a comparative analysis between the two counties.ResultsAll the 16 facilities assessed offered routine antenatal care (ANC) and normal delivery, but only two provided comprehensive emergency obstetric and newborn care (CEmONC). Most essential medicines, commodities, and required equipment were available. BEmONC and CEmONC guidelines were present in Kilifi, not in Kisii. One staff member was available 24/7 for cesarean section (CS) in each county, with one anesthetist in Kilifi. Electricity was accessible in all facilities, but only half had secondary power supply. Facilities offering CS had backup generators.ConclusionThe Facilities assessed had necessary drugs, commodities, equipment, and requirements, but staffing and guidelines were limited. Kilifi outperformed Kisii in most indicators. Additional support is needed for infrastructure and human resources to deliver quality maternal and newborn health services. Continuous monitoring will facilitate resource allocation based on facility needs.

Multilevel analysis of place of delivery among reproductive age women in Ethiopia

AbstractIntroductionThe place where the mother gives birth majorly affects the birth outcome and the mother's well‐being; this is because most maternal mortality, morbidity, and neonatal death occur during the time of labor and delivery and immediately after birth. This study was aimed to identify factors associated with the place of delivery among reproductive age women.MethodSecondary analysis was done using the 2019 Mini Ethiopian Demographic and Health Survey data. A multi‐stage sampling technique was used to select a total of 5527 weighted representative samples of women to include in the analysis. To identify factors associated with the place of delivery, a multilevel mixed effect binary logistic regression model was fitted to consider the hierarchical nature of the data. Statistical significance was declared at p‐value < 0.05.ResultThis study found that women aged 35 to 49 years, mothers with primary and secondary and above, educational status, and women from households with higher wealth index, and participants who had at least one antenatal care visit had higher odds of giving birth in a health facility. Women with two and three and more birth order, who live in rural areas, and women living in communities with higher poverty levels have lower odds of institutional delivery.ConclusionIncreased maternal age, increased maternal educational status, having at least one antenatal care visit, women's household wealth index, increased birth order, rural residence, and higher community poverty level were found to be factors that significantly associated with the place of delivery. Hence, Ethiopia's Federal Minister of Health and another stakeholders should amplify their efforts to increase the accessibility and availability of healthcare facilities and quality maternal health service delivery.

Evaluation of Use of Web-Based PolAc-D Application

Maternal and child health is a national policy that is one of the strategic plans, namely the challenge of making pregnancy safer. One of the main strategies implemented is to increase access and reach of quality maternal and neonatal health services to reduce maternal and infant mortality. PolAc-D is a web-based application that has been designed to monitor the health of pregnant women and fetuses. The purpose of this study was to evaluate the use of the PolAc-D application. The research method is a survey with a questionnaire that has been tested for validity and reliability, the sample used is all midwives who are in the Work Area of ​​the Langsa Baro Health Center, totaling 47 people. The results obtained a total score of 2,136, an average value of 45.4, for a maximum score of 53 and a minimum score of 39. These results mean that the evaluation of the use of the polAc-D application is very good, both in terms of use, application features that are easy to understand and according to the services that are carried out by midwives every day in providing services.

Multidomain and multilevel strategies to improve equity in maternal and newborn health services in Nepal: perspectives of health managers and policymakers

BackgroundNepal has committed to achieving universal coverage of quality maternal and newborn health (MNH) services by 2030. Achieving this, however, requires urgently addressing the widening inequity gradient in MNH care utilisation. This qualitative study examined the multidomain systemic and organisational challenges, operating in multi-level health systems, that influence equitable access to MNH services in Nepal.MethodsTwenty-eight in-depth interviews were conducted with health policymakers and program managers to understand supply-side perspectives of drivers of inequity in MNH services. Braun and Clarke’s thematic approach was employed in analysing the data. Themes were generated and explained using a multidomain (structural, intermediary, and health system) and multi-level (micro, meso and macro) analytical framework.ResultsParticipants identified underlying factors that intersect at the micro, meso and macro levels of the health system to create inequity in MNH services. Key challenges identified at the macro (federal) level included corruption and poor accountability, weak digital governance and institutionalisation of policies, politicisation of the health workforce, poor regulation of private MNH services, weak health management, and lack of integration of health in all policies. At the meso (provincial) level, identified factors included weak decentralisation, inadequate evidence-based planning, lack of contextualizing health services for the population, and non-health sector policies. Challenges at the micro (local) level were poor quality health care, inadequate empowerment in household decision making and lack of community participation. Structural drivers operated mostly at macro-level political factors; intermediary challenges were within the non-health sector but influenced supply and demand sides of health systems.ConclusionsMultidomain systemic and organisational challenges, operating in multi-level health systems, influence the provision of equitable health services in Nepal. Policy reforms and institutional arrangements that align with the country’s federalised health system are needed to narrow the gap. Such reform efforts should include policy and strategic reforms at the federal level, contextualisation of macro-policies at the provincial level, and context-specific health service delivery at the local level. Macro-level policies should be guided by political commitment and strong accountability, including a policy framework for regulating private health services. The decentralisation of power, resources, and institutions at the provincial level is essential for technical support to the local health systems. Integrating health in all policies and implementation is critical in addressing contextual social determinants of health.

Proportion and factors influencing client satisfaction with delivery services in health facilities in the Sissala East Municipality, Ghana: A cross-sectional study.

Client satisfaction is the difference between the healthcare services delivered and the needs of the client. Anecdotal evidence suggests the quality of maternal health and delivery services in Ghana especially in the Upper West Region is appalling. Moreover, there is a paucity of data on clients' satisfaction with maternal and delivery services rendered by healthcare. This study, therefore, assessed clients' satisfaction with delivery services and their associated factors. This analytical cross-sectional study included 431 women who had delivered in the last 7 days from four health facilities within Sissala East Municipality using a multistage and simple random sampling technique. A well-structured questionnaire was used to collect sociodemographic and client satisfaction data. All statistical analyses were done using Statistical Package for Social Sciences Version 26.0 and GraphPad Prism Version 8.0. A p < 0.05 was considered statistically significant. Clients' satisfaction with general delivery services was rated as 80.3% and was significantly associated with process-related factors (p < 0.0001) and structural-related factors (p < 0.0001) of the health facilities. This study found that health facilities' delivery services differed significantly and were associated with clients' satisfaction (p < 0.0001). Moreover, age group (p = 0.0200), occupation (p = 0.0090), kind of delivery (p = 0.0050), and delivery outcome (p < 0.0001) were significantly associated with client satisfaction with delivery services. More than two-thirds of women are satisfied with delivery services within selected health facilities in the Sissala East municipality, although satisfaction within health facilities differs. Furthermore, age group, occupation, kind of delivery, delivery outcome, process, and structural-related factors significantly contribute to client satisfaction with delivery services. To provide more comprehensive coverage of customers' satisfaction with delivery services in the municipality, strategiessuch as free maternal health initiatives and health education on the significance of facility delivery should be reinforced.

Pregnancy outcomes among Indian women: increased prevalence of miscarriage and stillbirth during 2015–2021

BackgroundPregnancy outcome is an important health indicator of the quality of maternal health. Adverse pregnancy outcomes is a major public health problem, which can lead to poor maternal and neonatal outcomes. This study investigates the trends in pregnancy outcomes prevalent during 2015–2021 in Indian women.MethodsThe study analysed the data presented in the fourth (2015-16) and fifth (2019-21) rounds of National Family Health Survey (NFHS). The absolute and relative changes in the birth outcomes of last pregnancy during the five years preceding the surveys were estimated using data collected from 195,470 women in NFHS-4 and from 255,549 women in NFHS-5.ResultsLivebirth decreased by 1.3 points (90.2% vs. 88.9%), and nearly half of the Indian states/UTs (n = 17/36) had lower than the national average of livebirth (88.9%) reported during 2019-21. A higher proportion of pregnancy loss was noted, particularly miscarriages increased in both urban (6.4% vs. 8.5%) and rural areas (5.3% vs. 6.9%), and stillbirth increased by 28.6% (0.7% vs. 0.9%). The number of abortions decreased (3.4% vs. 2.9%) among Indian women. Nearly half of the abortions were due to unplanned pregnancies (47.6%) and more than one-fourth (26.9%) of abortions were performed by self. Abortions among adolescent women in Telangana was eleven times higher during 2019-21 as compared to 2015-16 (8.0% vs. 0.7%).ConclusionOur study presents evidence of a decrease in the livebirth and an increase in the frequency of miscarriage and stillbirth among Indian women during 2015–2021. This study emphasises that there is a need of regional-specific, comprehensive and quality maternal healthcare programs for improving livebirth among Indian women.

Impact of COVID-19 pandemic on the availability of maternal and child health products and childhood vaccines

BackgroundIn many low- and middle-income countries, the 2019 novel coronavirus (COVID-19) has challenged efforts to ensure access to and availability of quality maternal, newborn, and child health (MCH) services and essential MCH commodities.ObjectivesThis study evaluated the impact of COVID-19 pandemic on the availability of maternal and child health products and childhood vaccines at selected health facilities in Ethiopia.MethodsWe have prospectively assessed 28 maternal–child health products and 14 childhood vaccines and accessories, which are listed in the Ethiopian national essential medicines list. Data were collected from 5 hospitals located in the Jimma zone of Oromia regional state in the southwestern part of Ethiopia. We extracted data on drug availability, and order fill rates for these pharmaceutical products between May 2019 and August 2020.ResultsThe overall mean availability of selected maternal and child health products was 43.2%. It was 52.9% (range 21.0–63.6%) prior COVID-19 and 42.6% (range 19–56.4) during COVID-19 time. The average monthly orders fill rates of hospitals for the selected products ranged from 39 to 79%. Before COVID-19 the average order fill rate was near 70% of total orders placed by the hospitals. However, immediately after the COVID-19 case notification in Ethiopia, the percentage of order filled correctly in items and quantities began decreasing.ConclusionThis study illustrates that the availability of key essential medicines for maternal and child health in the study area was low. The overall stock-out situation of MCH products has worsened during COVID-19 compared to pre-COVID-19 pandemic. None of the surveyed MCH products met the ideal availability benchmark of 80% in the public hospitals. To allow governments to guarantee these products are constantly available and affordable, a variety of policy frameworks and choices addressing inevitable epidemics should exist.

Faktor-Faktor yang Berhubungan dengan Pemeriksaan Kehamilan (K4) di Puskesmas Buay Pemaca Kabupaten Ogan Komering Ulu (OKU) Selatan Tahun 2021

According to the World Health Organization (WHO) in 2017, the maternal mortality rate (MMR) is still very high, around 810 women die from complications related to pregnancy or childbirth worldwide every day, and around 295,000 women die during and after pregnancy and childbirth. Efforts to accelerate the reduction of the Maternal Mortality Rate (MMR) are carried out by ensuring that every mother is able to access quality maternal health services. The low number of pregnant women who do can be influenced by several factors. The factors that influence pregnant women to perform antenatal care are knowledge, attitudes, parity, economy, socio-culture, education and husband's support. The purpose of this study was to determine the relationship between knowledge, education and husband's support with antenatal care at the Keramasan Health Center Palembang in 2021. The research design used an Analytical Survey with a Cross Sectional approach. The population in this study were pregnant women in the third trimester (gestational age of more than 28-40 weeks) who came to check their pregnancy in August - September at the Keramasan Palembang Health Center, totaling 64 people. The sampling technique in this study was carried out by accidental sampling with a total sample of 64 respondents. Data collection using a questionnaire sheet. Data analysis using univariate analysis and bivariate analysis using chi square test. The results of the study showed that there was a relationship between knowledge (p value = 0.037), education (p value = 0.013) and husband's support (p value = 0.008) with pregnancy examinations at the Keramasan Health Center Palembang in 2021. It is hoped that the results of this study can be an illustration for the puskesmas to can further increase the visits of pregnant women in their working areas by providing information to pregnant women about the schedule and benefits of prenatal care.

Health and economic benefits of achieving contraceptive and maternal health targets in Small Island Developing States in the Pacific and Caribbean

IntroductionReducing unmet need for modern contraception and expanding access to quality maternal health (MH) services are priorities for improving women’s health and economic empowerment. To support investment decisions, we estimated...

Ensuring quality obstetric care in rural Ghana: Shared experiences of obstetric care providers

PurposeTo explore care provider lived experiences with obstetric care delivery in rural Ghana. MethodsThis interpretative phenomenological study utilised a semi-structured interview guide to collect data on care provider lived experiences with obstetric care delivery. Participants comprised purposively sampled obstetric care providers in selected health care facilities in the Northern Region of Ghana. Data processing and presentation followed interpretative phenomenological analysis procedure. ResultsFindings reveal four superordinate themes: being persuasive, striving to provide quality care, using evasive mechanisms and subtle preventive schemes. These specifically refer to the use of alternative care, soliciting partner involvement, voluntarily donating blood, stocking essential items and drugs, refusing care in some instances and performing unconsented interventions. ConclusionIn their quest to provide quality care, obstetric care providers in some of Ghana’s rural health facilities adopt a mix of altruistic, innovative, excessive and unethical approaches most of which are driven by systemic failures. A government-community collaboration and commitment to quality maternal health care delivery is essential to improving health outcomes of rural mothers.

Maternal Centric Measurement and Data Gaps in Addressing Maternal Morbidities: A Scoping Review.

The objectives of this project were to (1) describe maternal-centric measures and survey data which are publicly available to evaluate the incidence, frequency, and distribution of maternal morbidity in the postpartum period, and (2) to identify postpartum care quality improvement targets and outline the types of measurement and data required to support them. We conducted a scoping review of two types of data sources: maternal health quality measures used by providers and payers and nationally-representative survey data sets administered by federal agencies. Each source was searched for keywords associated with pregnancy and the postpartum period. We included quality measures and survey questions that are maternal-centric and addressed the postpartum period. We excluded infant-centric measures and data. Quality measures were organized according to the Donabedian quality model. Our analysis demonstrates that existing maternal-centric quality measures and survey data offer limited insight into diagnosis and patient care delivery experiences associated with maternal morbidities during the postpartum period. There is inadequate maternal-centric data on the incidence, frequency, and distribution of postpartum maternal morbidities and associated care use. This gap reduces the ability of research to estimate the incidence of illness and injury among postpartum women and create targeted quality improvement efforts. Our findings highlight the need for quality measure stewards and data sponsors to enhance data collection and methods to become more inclusive of maternal-centric outcomes during the postpartum period.

The proposed need for integrated maternal and child oral health policy: A case of South Africa.

The high oral disease burden among children in South Africa, specifically early childhood caries, has received scant attention despite the fact that it is a public health concern that negatively impacts the overall well-being and quality of life of the child. While South Africa has a number of well documented policies that focus on oral health in general and maternal and prenatal health, none specifically addresses the oral health of children under the age of six years. The integration of oral health in maternal and child health care in South Africa could lead to an improved oral health quality of life and better oral health outcomes for mothers and children to address the high prevalence of childhood caries and unmet treatment needs for this population. While the integration of oral health care into primary healthcare is recognised as crucial and affordable, it however continues to be neglected. In South Africa, oral health disparities are attributed to the unequal distribution of oral health services, and policies that govern oral, maternal and child health seem to work in parallel with one another. Integrating oral health into interventions for primary health care delivery is a cost-effective way to improve the health of disadvantaged groups. Considering that maternal oral health predicts children's oral health and primary health care teams regularly see under-6-year-olds, this primary care setting is ideal for integration of these services. Despite growing interest in an integrated oral health and primary care system, there is little literature on oral health integration models. Improving the oral health of vulnerable populations requires integrating oral health into primary care and implementing interdisciplinary public health programs. The development of an Integrated Maternal and Child Oral Health policy would play a critical role in advancing integration; however, such a policy should be designed with both implementation and translation in mind for it to be successfully followed through. Such a policy should be comprehensive and contextual, aimed at increasing access to oral health services for women and children and reduce the oral disease burden. This paper proposes and describes the possible content and objectives of such a policy that will enhance effective leadership and accountability and strengthen health system delivery platforms for quality maternal and child oral health services along the continuum of healthcare. Furthermore, it will illustrate the importance of a policy that aims to promote coordinated, relevant, trans-multi-disciplinary and inter-sectoral community engagement to improve pregnancy and oral health outcomes, and importantly, establish a sustainable and contextual surveillance system for maternal and child oral health.

Measures adopted by indigent mothers in Kilifi County to tackle maternal health challenges during the COVID-19 pandemic: A qualitative study.

Many sub-Saharan African countries have experienced various challenges that threaten the quality of health services offered to the population. The COVID-19 pandemic disrupted access to healthcare services in many countries as they grappled with implementing measures to curb its spread. The consequences of COVID-19 have been catastrophic for maternal and newborn health. There is a dearth of information on expectant mothers' negotiation mechanisms to access maternal health services during COVID-19 in Kenya. This rapid qualitative study draws data from purposefully selected 15 mothers who were either pregnant or had newborn babies during the COVID-19 pandemic in Kilifi county in Kenya. Data were analyzed thematically and presented in a textual description. Women used the following alternatives to access maternal health: giving birth at the homes of traditional birth attendants (TBAs), substituting breastfeeding with locally available food supplements, relying on limited resources and neighbours for delivery and local savings and rotating credit associations. This study shows that urgent measures are needed to provide high quality maternal and child health services during and after the COVID-19 pandemic. These include but are not limited to developing special interventions for the pregnant women for any emergency and establishing trust between communities and individuals through the TBAs.

Maternal risk factors of COVID-19-affected pregnancies: A comparative analysis of symptomatic and asymptomatic COVID-19 from the Q-PRECIOUS registry.

The novel coronavirus disease 2019 (COVID-19) pandemic has had consequences on the pregnant population, as disease severity is associated with the quality of maternal health and pregnancy complications, increasing maternal and neonatal morbidity. Worldwide descriptive data help describe risk factors that could predict symptomatic and severe COVID-19 in pregnancy. To describe demographic features and risk factors of pregnant women with COVID-19 in Qatar and compare symptomatic versus asymptomatic disease. Clinical characteristics and risk factors of pregnant women with COVID-19 in Qatar from March 2020 to March 2021 was retrospectively reviewed, comparing the cohort with the general pregnant population. Crude and adjusted odds ratios (aORs) were computed, comparing symptomatic versus asymptomatic infection. Of the 500 women, 347 reported at least one symptom at diagnosis (347/500; 69.4%). The majority fell in the 30-39 years age group (241/500; 48%), with more than half in the obese body mass index (BMI) category. The cohort was 66% (332/500) Qatari women, compared with the 26% expected in the population (26.4% vs 66.4% p<0.001). Compared with the 2019 national statistics, the number of women was higher in the >40 years age group (5% vs 7.6%, p=0.027) and grand multiparous group (5.4% vs 13.6%, p<0.001). The symptom most commonly reported by the symptomatic group was cough (276/500; 55%), followed by fever, fatigue, and myalgia. In the adjusted analysis, the symptomatic group had 2.7 times higher odds of being asthmatic (OR=2.67, 95% CI 1.1-6.7, p=0.037). Women aged >40 years had 6.6 times higher odds of symptomatic disease (aOR=6.6, 95% CI 1.08-39.73, p=0.041). A history of contact with a patient with symptomatic COVID and earlier gestational age at diagnosis increased the odds (aOR=2.06, 95% CI 1.2-3.54, p=0.009; aOR=0.73 95% CI 0.57-0.96; p=0.017). This study cohort included significantly more Qatari women, older women, grand multiparous women, a higher proportion with pre-existing and gestational diabetes, and higher BMI than national data. In addition, contact to a patient with symptomatic disease, history of asthma, older age, and earlier gestational age at diagnosis were significantly associated with symptomatic disease.

EFEKTIFITAS ANTENATAL RISK QUESTIONNAIRE (ANRQ) DALAM DETEKSI DINI FAKTOR RESIKO GANGGUAN PSIKOLOGIS IBU HAMIL

Psychological disorders in pregnant women are very at risk of causing various health problems in both the mother and fetus. The implementation of early detection of risk factors for psychological disorders of pregnant women should be pursued regularly using effective instruments. The purpose of this study is to find out the effectiveness of antenatal risk questionnaire (ANRQ) in identifying risk factors for psychological disorders for pregnant women. This study is a literature review that searches the library through google scholar and pubmed with the keyword Antenatal Risk Questionnaire to Assess Psychosocial Risk Factors on english data base and keyword detection of mental disorders of pregnant women in indonesian data base. The search results obtained 7 literature that were reviewed after passing the elimination process ranging from identification, screening of inclusion and exclusion criteria, literature feasibility and inclued according to the purpose of the study. The results of the study make it clear that (ANRQ) is effectively used to detect early psychological disorders of pregnant women and reliable in predicting as early as possible so that immediate care can be done for the improvement of maternal psychological health problems. It is expected that the application of use (ANRQ) can be done regularly in the practice of maternity care services in order to create quality maternal mental and physical health

Quality of emergency obstetric and newborn care services in Wolaita Zone, Southern Ethiopia

BackgroundGlobally, nearly 295,000 women die every year during and following pregnancy and childbirth. Emergency obstetric and newborn care (EmONC) can avert 75% of maternal mortality if all mothers get quality healthcare. Improving maternal health needs identification and addressing of barriers that limit access to quality maternal health services. Hence, this study aimed to assess the quality of EmONC service and its predictors in Wolaita Zone, southern Ethiopia.MethodologyA facility-based cross-sectional study was conducted in 14 health facilities. A facility audit was conducted on 14 health facilities, and 423 women were randomly selected to participate in observation of care and exit interview. The Open Data Kit (ODK) platform and Stata version 17 were used for data entry and analysis, respectively. Frequencies and summary statistics were used to describe the study population. Simple and multiple linear regressions were done to identify candidate and predictor variables of service quality. Coefficients with 95% confidence intervals were used to declare the significance and strength of association. Input, process, and output quality indices were created by calculating the means of standard items available or actions performed by each category and were used to describe the quality of EmONC.ResultThe mean input, process, and output EmONC services qualities were 74.2, 69.4, and 79.6%, respectively. Of the study participants, 59.2% received below 75% of the standard clinical actions (observed quality) of EmONC services. Women’s educational status (B = 5.35, 95% C.I: 0.56, 10.14), and (B = 8.38, 95% C.I: 2.92, 13.85), age (B = 3.86, 95% C.I: 0.39, 7.33), duration of stay at the facility (B = 3.58, 95% C.I: 2.66, 4.9), number of patients in the delivery room (B = − 4.14, 95% C.I: − 6.14, − 2.13), and care provider’s experience (B = 1.26, 95% C.I: 0.83, 1.69) were independent predictors of observed service quality.ConclusionThe EmONC services quality was suboptimal in Wolaita Zone. Every three-in-five women received less than three-fourths of the standard clinical actions. The health system, care providers, and other stakeholders should emphasize improving the quality of care by availing medical infrastructure, adhering to standard procedures, enhancing human resources for health, and providing standard care regardless of women’s characteristics.

STUDI KASUS : ASUHAN KEBIDANAN PADA Ny.W MASA KEHAMILAN TRIMESTER III, PERSALINAN, NIFAS, NEONATUS DAN KELUARGA BERENCANA

During the Covid-19 pandemic, there was a decrease in the coverage of pregnancy services compared to the previous year. Especially during a pandemic like this sometimes pregnant women don't want to check themselves and their wombs for fear of being exposed to the Covid-19 virus. Continuity of Care (COC) or comprehensive midwifery care is a sustainable midwifery service and is one way to reduce MMR and IMR, especially those that occur at the Maos Health Center by providing care for pregnant women in the third trimester, childbirth, postpartum, neonates and family planning, at the Maos Health Center.&#x0D; With the provision of comprehensive midwifery care, it is hoped that every pregnant woman will get quality maternal health services so that mothers and babies remain healthy and can reduce maternal and infant mortality rates.

Summer 2022 Regulatory Affairs and Quality Measure Update

Quality & Regulatory| September 2022 Summer 2022 Regulatory Affairs and Quality Measure Update Matthew Goldan; Matthew Goldan Search for other works by this author on: This Site PubMed Google Scholar Claire Ostarello; Claire Ostarello Search for other works by this author on: This Site PubMed Google Scholar Matthew T. Popovich, PhD Matthew T. Popovich, PhD Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor September 2022, Vol. 86, 19–20. https://doi.org/10.1097/01.ASM.0000874232.52262.3f Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Cite Icon Cite Get Permissions Search Site Citation Matthew Goldan, Claire Ostarello, Matthew T. Popovich; Summer 2022 Regulatory Affairs and Quality Measure Update. ASA Monitor 2022; 86:19–20 doi: https://doi.org/10.1097/01.ASM.0000874232.52262.3f Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsASA Monitor Search Advanced Search Topics: quality indicators Summertime is an active season for ASA physicians and staff who review and respond to regulatory proposals. The ASA Department of Quality and Regulatory Affairs works with physician committees and leadership to ensure our member priorities are heard among federal regulators. Each year, the Centers for Medicare & Medicaid Services (CMS) releases its Inpatient Prospective Payment System (IPPS) proposed rule that sets forth yearly policy on Medicare Part A and hospital-level initiatives. This year, CMS included a broad range of proposals and requests for information (RFIs) on issues directly affecting ASA members, from the COVID-19 Public Health Emergency (PHE) to maternal health quality measures to climate change. In a letter to CMS, ASA took the opportunity to advocate strongly for physician-led anesthesia care while sharing the anesthesiologist's perspective in key issues in patient care and departmental administration. A significant focus of ASA's letter targeted the Anesthesia Services Physician Supervision Rule... You do not currently have access to this content.

Maternal and child health data quality in health care facilities at the Cape Coast Metropolis, Ghana

BackgroundThe demand for quality maternal and child health (MCH) data is critical for tracking progress towards attainment of the Sustainable Development Goal 3. However, MCH cannot be adequately monitored where health data are inaccurate, incomplete, untimely, or inconsistent. Thus, this study assessed the level of MCH data quality.MethodA facility-based cross-sectional study design was adopted, including a review of MCH service records. It was a stand-alone study involving 13 healthcare facilities of different levels that provided MCH services in the Cape Coast Metropolis. Data quality was assessed using the dimensions of accuracy, timeliness, completeness, and consistency. Health facilities registers were counted, collated, and compared with data on aggregate monthly forms, and a web-based data collation and reporting system, District Health Information System (DHIS2). The aggregate monthly forms were also compared with data in the DHIS2. Eight MCH variables were selected to assess data accuracy and consistency and two monthly reports were used to assess completeness and timeliness. Percentages and verification factor were estimated in the SPSS version 22 package.ResultsData accuracy were recorded between the data sources: Registers and Forms, 102.1% (95% CI = 97.5%—106.7%); Registers and DHIS2, 102.4% (95% CI = 94.4%—110.4%); and Forms and DHIS2, 100.1% (95% CI = 96.4%—103.9%). Across the eight MCH variables, data were 93.2% (95% CI = 82.9%—103.5%) complete in Registers, 91.0% (95% CI = 79.5%—102.5%) in the Forms, and 94.9% (95% CI = 89.9%—99.9%) in DHIS2 database. On the average, 87.2% (95% CI = 80.5%—93.9%) of the facilities submitted their Monthly Midwife’s Returns reports on time, and Monthly Vaccination Report was 94% (95% CI = 89.3%—97.3%). The overall average data consistency was 93% (95% CI = 84%—102%).ConclusionGiven the WHO standard for data quality, the level of MCH data quality in the health care facilities at the Cape Coast Metropolis, available through the DHIS2 is complete, reported on timely manner, consistent, and reflect accurately what exist in facility’s source document. Although there is evidence that data quality is good, there is still room for improvement in the quality of the data.