Quality of Care in Delivery Service at Public Health Institutions in Bahir Dar Town, Ethiopia.
| dc.contributor.advisor | Tsigie Yoseph | |
| dc.contributor.author | Tamene Michael | |
| dc.date.accessioned | 2020-07-15T06:15:49Z | |
| dc.date.accessioned | 2023-11-06T08:54:47Z | |
| dc.date.available | 2020-07-15T06:15:49Z | |
| dc.date.available | 2023-11-06T08:54:47Z | |
| dc.date.issued | 2012-06 | |
| dc.description.abstract | Background: Delivery and the time immediately after, is the most critical stage for every pregnancy, and this is the stage where quality of care available does matter. 99% of world’s maternal deaths occur in developing countries. More than half of these deaths occur in sub Saharan Africa including Ethiopia, and most were avoidable .Ethiopia’s maternal mortality rate continues at an unacceptably high level. The percentage of deliveries attended by skilled health personnel at health institutions declined from 18.4% in 2009 to 16.8% in 2010, which is much below the target of 37.0% .This percentage, is very low ,largely below the Sub Saharan Africa averageof 47% in 2009 and very far from MDG target of 90% coverage. This is because of actual quality of care for deliveries have received relatively less research attention than other areas of health care. Objective: The objective of this study is to assess the quality of delivery services at public health institutions in Bahir Dar town, Amhara regional state, Ethiopia. Methods: Quantitative cross-sectional study was conducted on three health facilities from September 2011 to May 2012. Convenient non-probability sampling technique was used and samples were allocated proportionally to each facility according to their previous year delivery uptake. Data was collected using three data collection instruments; Exit Interview, Observation and facility assessment. Data entry, cleaning and analysis, using descriptive values and binary logistic regression for association test, were done. Result: A total of 400 delivering mothers for exit interview and 40 deliveries for observation were participated from Felege Hiwot referral hospital, Bahir Dar and Han health centers. In exit interview, the study revealed that 216 (54%) of mothers were satisfied while 184 (46%) dissatisfied with the delivery care given. A total of 167 (41.8%) of mothers satisfy with the distance over home to facility. Among other facility related satisfaction; cleanliness of toilets, overall cleanliness and comfort of the waiting area and examination room satisfaction were the first three least values; 184 (46.0%), 179 (47.1%) and 198 (49.5%) respectively. Regarding care provider related satisfaction completeness of information given by health professionals, measures taken to assure privacy and feeling of confidentiality were the first least values according to mothers view; 163 (40.8%), 169 (42.2%) and 196 (49.0%) respectively. After adjusting for confounding socio demographic factors maternal age and monthly income were significantly associated with satisfaction of delivery services. When obstetric factors were adjusted; parity, maternal and fetal outcomes had significantly associated with mothers’ satisfaction (p-values<0.05). During observation, it was revealed that in 46% of cases health providers performed well while, 54% of them not performed well. Providers who introduce themselves were only 15% while only 40% of providers seen greeting the woman with kindness and respect. No provider encourages the woman to ask questions or explain procedures before performed except in one of cases for each. Three quarter of the providers did not maintained privacy. Labor and delivery services were available in all the three health institutions 24 hours a day, every day. However, availability of personnel as the main task in delivery care during duty times was abscent in both of health centers. Client privacy related issues were commonly lacking infrastructures in the delivery room of the three facilities. Drug shortage was prominent in Han health center. Basic equipment and supplies were fairly available and adequate than other components in all health facilities. Conclusion and Recommendation: The overall quality of care in delivery services at public health institutions found to be suboptimal and the current performance of providers was found to be below the average. There were a lack of service availability, infrastructure, personnel, essential drugs, equipments and supplies essential to quality of delivery care. Therefore, strengthen health systems by providing indicators to measure and compare the quality of delivery care services provided at each level of health facility, make provider training and capacity building the pillar of delivery services and improvement of basic infrastructures for performance of delivery service to reduce maternal and newborn mortality in line with MDGs 4 and 5 are recommended. | en_US |
| dc.identifier.uri | http://etd.aau.edu.et/handle/123456789/21912 | |
| dc.language.iso | en_US | en_US |
| dc.publisher | Addis Ababa University | en_US |
| dc.subject | Quality of care , delivery service , public health institutions | en_US |
| dc.title | Quality of Care in Delivery Service at Public Health Institutions in Bahir Dar Town, Ethiopia. | en_US |
| dc.type | Thesis | en_US |