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Published in: BMC Pregnancy and Childbirth 1/2013

Open Access 01-12-2013 | Research article

Quality of intrapartum care at Mulago national referral hospital, Uganda: clients’ perspective

Authors: Omar Kigenyi, Getachew B Tefera, Elizabeth Nabiwemba, Christopher G Orach

Published in: BMC Pregnancy and Childbirth | Issue 1/2013

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Abstract

Background

Quality of intrapartum care is an important intervention towards increasing clients’ utilization of skilled attendance at birth and accelerating improvements in newborn’s and maternal survival and wellbeing. Ensuring quality of care is one of the key challenges facing maternal and neonatal services in Uganda. The study assessed quality of intrapartum care services in the general labor ward of the Mulago national referral and teaching hospital in Uganda from clients’ perspective.

Methods

A cross sectional study was conducted using face to face interviews at discharge with 384 systematically selected clients, who delivered in general labor ward at Mulago hospital during May, 2012. Data analysis was done using STATA Version (10) software. Means and median general index scores for quality of intrapartum care services were calculated. Linear regression models were used to determine factors associated with quality of care.

Results

Overall, quality of intrapartum care mean index score was 49.4 (standard deviation (sd) 15.46, and the median (interquartile range (IQR)) was 49.1 (37.5–58.9). Median index scores (IQR) per selected quality of care indicators were; dignity and respect 75 (50–87.5); relief of pain and suffering 71.4 (42.8-85.7); information 42.1 (31.6-55.3); privacy and confidentiality 33.3 (1–66.7); and involvement in decision making 16.7 (1–33.3). On average, higher educational level (college/university) (β: 6.81, 95% CI: 0.85-15.46) and rural residence of clients (β: 5.67, 95% CI: 0.95-10.3) were statistically associated with higher quality scores.

Conclusion

This study has revealed that quality of intrapartum care services from clients’ perspective was low. Improvements should be focused on involving clients in decision making, provision of information about their conditions and care, and provision of privacy and confidentiality. There is also need to improve the number and availability of health care providers in the labor ward.
Literature
1.
go back to reference Lawn JE, Kinney M, Lee ACC, Chopra M, Donnay F, Paul VK, Bhutta ZA, Bateman M, Darmstadt GL: Reducing intrapartum-related deaths and disability: can the health system deliver?. Int J Gyne & Obs. 2009, 107: S123-S142.CrossRef Lawn JE, Kinney M, Lee ACC, Chopra M, Donnay F, Paul VK, Bhutta ZA, Bateman M, Darmstadt GL: Reducing intrapartum-related deaths and disability: can the health system deliver?. Int J Gyne & Obs. 2009, 107: S123-S142.CrossRef
2.
go back to reference Clark S, Belfort M, Dildy G, Herbst M, Meyers J, Hankins G: Maternal death in the 21st century: causes, prevention, and relationship to cesarean delivery. Am J Obs & Gyne. 2008, 199 (36): e1-e5. discussion 91–2.e7-11CrossRef Clark S, Belfort M, Dildy G, Herbst M, Meyers J, Hankins G: Maternal death in the 21st century: causes, prevention, and relationship to cesarean delivery. Am J Obs & Gyne. 2008, 199 (36): e1-e5. discussion 91–2.e7-11CrossRef
3.
go back to reference Lawn JE, Lee ACC, Kinney M, Sibley L, Carlo WA, Paul VK, Pattinson R, Darmstadt GL: Two million intrapartum-related stillbirths and neonatal deaths: where, why, and what can be done?. Int J Gyne & Obs. 2009, 107: S5-S19.CrossRef Lawn JE, Lee ACC, Kinney M, Sibley L, Carlo WA, Paul VK, Pattinson R, Darmstadt GL: Two million intrapartum-related stillbirths and neonatal deaths: where, why, and what can be done?. Int J Gyne & Obs. 2009, 107: S5-S19.CrossRef
4.
go back to reference Baba J: Practices and quality of intraprtum care in the main referral hospital of the Gambia. 2008, University of Oslo Norway: Master of philosophy degree in International community health, faculty of medicine Baba J: Practices and quality of intraprtum care in the main referral hospital of the Gambia. 2008, University of Oslo Norway: Master of philosophy degree in International community health, faculty of medicine
5.
go back to reference Ronsmans C, Graham WJ: Maternal mortality: who, when, where and why. Lancet. 2006, 368: 1189-1200. 10.1016/S0140-6736(06)69380-X.CrossRefPubMed Ronsmans C, Graham WJ: Maternal mortality: who, when, where and why. Lancet. 2006, 368: 1189-1200. 10.1016/S0140-6736(06)69380-X.CrossRefPubMed
6.
go back to reference Policy-Project: Maternal and neonatal program effort index: a tool for maternal health advocates. 2002, Washington DC: Futures group Policy-Project: Maternal and neonatal program effort index: a tool for maternal health advocates. 2002, Washington DC: Futures group
7.
go back to reference GOU: Population and reproductive health, broadening opportunities for development. State of Uganda Population Report. 2011, Kampala: GOU GOU: Population and reproductive health, broadening opportunities for development. State of Uganda Population Report. 2011, Kampala: GOU
8.
go back to reference Ministry of Health: Roadmap for accelerating reduction of maternal and newborn mortality and morbidity in Uganda. 2006, Kampala: Ministry of Health Ministry of Health: Roadmap for accelerating reduction of maternal and newborn mortality and morbidity in Uganda. 2006, Kampala: Ministry of Health
9.
go back to reference Policy-Project: Maternal and neonatal program effort: a tool for maternal health advocates. 2005, Washington DC: Futures group Policy-Project: Maternal and neonatal program effort: a tool for maternal health advocates. 2005, Washington DC: Futures group
10.
go back to reference Health Sector Strategic Plan 2000/01-2004/05 for Ministry of Health: Midterm Review Report. 2003, Kampala: Health Sector Strategic Plan 2000/01-2004/05 for Ministry of Health: Midterm Review Report. 2003, Kampala:
11.
go back to reference Government of Uganda: Health sector strategic plan 2010/11-2014/15. Government of Uganda Report. 2011, Kampala: Government of Uganda Government of Uganda: Health sector strategic plan 2010/11-2014/15. Government of Uganda Report. 2011, Kampala: Government of Uganda
12.
go back to reference Dodwell M, Newburn M: Normal birth as a measure of the quality of care: Evidence on safety, effectiveness and women’s experiences. 2010, London: NCT Dodwell M, Newburn M: Normal birth as a measure of the quality of care: Evidence on safety, effectiveness and women’s experiences. 2010, London: NCT
13.
go back to reference Darzi A: High quality care for all. 2008, London: NHS Next Stage Review Final Report Darzi A: High quality care for all. 2008, London: NHS Next Stage Review Final Report
14.
go back to reference Weisman Carol S, Grason Holly A, Strobino Donna S: Quality management in public and community health: examples from women’s health. Quality Management in Health care. 2001, 10: 54-64.CrossRef Weisman Carol S, Grason Holly A, Strobino Donna S: Quality management in public and community health: examples from women’s health. Quality Management in Health care. 2001, 10: 54-64.CrossRef
15.
go back to reference Lochoro P: Measuring patient satisfaction in Uganda Catholic medical bureau. Health policy dev. 2004, 2: 243-248. Lochoro P: Measuring patient satisfaction in Uganda Catholic medical bureau. Health policy dev. 2004, 2: 243-248.
16.
go back to reference Mulago hospital 2008/09-2012/13: Strategic Plan. 2009, Kampala: Mulago hospital 2008/09-2012/13: Strategic Plan. 2009, Kampala:
17.
go back to reference Sloan JA, Novotny PJ, Loprinzi CL: Analyzing quality of life (QOL) endpoints in clinical trials via the SAS system. 1998, Nashville, TN: Sloan JA, Novotny PJ, Loprinzi CL: Analyzing quality of life (QOL) endpoints in clinical trials via the SAS system. 1998, Nashville, TN:
18.
go back to reference Bowley AL: Elements of Statistics. 1920, New York, C. Scribner's sons: London, P.S. King & Son ltd Bowley AL: Elements of Statistics. 1920, New York, C. Scribner's sons: London, P.S. King & Son ltd
19.
go back to reference Nabbuye-Sekandi J, Makumbi FE, Kasangaki A, Kizza IB, Tugumisirize J, Nshimye E, Mbabali S, Peters DH: Patient satisfaction with services in outpatient clinics at Mulago hospital, Uganda. Int J for Quality in Health Care. 2011, 23: 516-523. 10.1093/intqhc/mzr040.CrossRef Nabbuye-Sekandi J, Makumbi FE, Kasangaki A, Kizza IB, Tugumisirize J, Nshimye E, Mbabali S, Peters DH: Patient satisfaction with services in outpatient clinics at Mulago hospital, Uganda. Int J for Quality in Health Care. 2011, 23: 516-523. 10.1093/intqhc/mzr040.CrossRef
20.
go back to reference Lewis S: Patient centered care: an introduction to what it is and how to achieve it a discussion paper for Saskatchewan ministry of health. 2009, Saskatoon SK: Access consulting Ltd Lewis S: Patient centered care: an introduction to what it is and how to achieve it a discussion paper for Saskatchewan ministry of health. 2009, Saskatoon SK: Access consulting Ltd
21.
go back to reference Fawcus S: Pain relief at Mowbray maternity hospital: Audit and intervention. 21st conference on priorities in perinatal care. 2002, South Africa: priorities in perinatal care association Fawcus S: Pain relief at Mowbray maternity hospital: Audit and intervention. 21st conference on priorities in perinatal care. 2002, South Africa: priorities in perinatal care association
22.
go back to reference Penn-Kekana L: The use of analgesia in labour wards in two district hospitals. 22nd conference on priorities in perinatal care. 2003, South Africa: priorities in perinatal care association Penn-Kekana L: The use of analgesia in labour wards in two district hospitals. 22nd conference on priorities in perinatal care. 2003, South Africa: priorities in perinatal care association
23.
go back to reference Brown H: Better births initiative: initiating change in obstetric care. 20th conference on priorities in perinatal care. 2001, South Africa: priorities in perinatal care association Brown H: Better births initiative: initiating change in obstetric care. 20th conference on priorities in perinatal care. 2001, South Africa: priorities in perinatal care association
24.
go back to reference Farrell EM, Pattinson B: Intrapartum care in South Africa. review and guidelines. Edited by: Macdonald P. 2005, South Africa: medical research council Farrell EM, Pattinson B: Intrapartum care in South Africa. review and guidelines. Edited by: Macdonald P. 2005, South Africa: medical research council
25.
go back to reference Pitchforth E, Lilford R, Asres G, Stanford C, Frost J: Assessing and understanding quality of care in a labour ward: a pilot study combining clinical and social science perspectives in Gondar, Ethiopia. Soc Sci Med. 2011, 71: 1739-1748.CrossRef Pitchforth E, Lilford R, Asres G, Stanford C, Frost J: Assessing and understanding quality of care in a labour ward: a pilot study combining clinical and social science perspectives in Gondar, Ethiopia. Soc Sci Med. 2011, 71: 1739-1748.CrossRef
26.
go back to reference Bergstrom S: Quality and audit of maternity care. 2003, London: RCOG Press Bergstrom S: Quality and audit of maternity care. 2003, London: RCOG Press
27.
go back to reference Institute of Medicine: Educating health professional to be patient centered. Current reality, barriers and related actions. 2001, Washington DC: National Academy of Science Institute of Medicine: Educating health professional to be patient centered. Current reality, barriers and related actions. 2001, Washington DC: National Academy of Science
28.
go back to reference Ministry of Health: Sector Performance 2009/2010. Annual Report. 2010, Kampala Ministry of Health: Sector Performance 2009/2010. Annual Report. 2010, Kampala
Metadata
Title
Quality of intrapartum care at Mulago national referral hospital, Uganda: clients’ perspective
Authors
Omar Kigenyi
Getachew B Tefera
Elizabeth Nabiwemba
Christopher G Orach
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2013
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-13-162

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