Assessment of Quality of Delivery Services at Public Health Institutions in Bishoftu Town, Oromia Region, Ethiopia
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Date
2017-06
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Addis Ababa University
Abstract
Background: Ethiopia is one of the countries with high maternal and prenatal mortality. Interventions targeted from pre-pregnancy to postnatal period had proved to have a positive effect on maternal and newborn outcomes. However, in Ethiopia, health facility delivery is very low only at 28%. Low quality of care in health facilities is one of the factors that contribute to the low service uptake in Ethiopia among other reasons. Though many had indicated the low service uptake for delivery services, there is a paucity of research about the quality of delivery services at public health facilities. Hence, this study was planned to assess the quality of delivery services in public health facilities of Bishoftu town using Donabedian frame work.
Objectives: To assess the quality of delivery services at public health institution in Bishoftu town, Oromia Region, Ethiopia
Methods: We used a mixed research method combining a facility based cross-sectional quantitative and qualitative studies in all public health facilities of Bishoftu town. The quantitative study was conducted among 254 clients who delivered at health facilities during the study period. All health providers (n=21) who attended women during labor, delivery, and in the immediate postpartum period have participated in the qualitative study. Availability of necessary resources for delivery services was identified using observation checklist. Data were entered and cleaned using Epi- Info version 3.5.3 and analyzed using SPSS version 21. Qualitative data were analyzed using thematic content analysis.
Result: Most of the health facilities didn’t provide all components of basic emergency obstetric and newborn care signal functions. Mean percentage of respectful maternity care (39%) and knowledge of providers were low. Overall satisfaction of clients was 58.7%. Women who were at secondary level of education and above [AOR = 0.33, 95%CI: (0.12-0.96)], who had operative mode of delivery [AOR= 0.20, 95% CI: (0.08-0.47)], and whose newborn outcome was complicated [AOR= 0.04, 95% CI: (0.003-0.50)] were less likely to be satisfied with the delivery care they got from public health facilities. Women who had planned pregnancy [AOR= 3.24, 95% CI: (1.44-7.30)] were more likely to be satisfied with the services they obtained.
Conclusion and recommendation: Quality of delivery services was suboptimal which is explained by lack of Basic Emergency Obstetric and Neonatal Care signal functions. The low level client satisfaction could have resulted from the suboptimal services. Strengthing the BEmONC signal functions and training on respectful and compassionate care is important
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Quality of Delivery Services at Public Health Institutions