The practice of labor analgesia and its perceived Barriers Among Health Care providers Working in public Hospitals of Addis Ababa, Ethiopia
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Date
2016-06
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Addis Abeba University
Abstract
Background: Almost all women experience moderate-to-severe pain during labor which adversely affects
parturient and fetuses. Authorities in the fields of obstetrics and anaesthesia encourage use of labour
analgesia. The practice of labor analgesia in Africa is not a well-established service, especially in the low-
income countries like Ethiopia. The goal of this study was to assess the practice of labour analgesia and its
perceived barriers among health care providers working in public hospitals of Addis Ababa, Ethiopia.
Methods and materials: Institutional based cross sectional study was conducted in four public hospitals
of Addis Ababa. Cluster sampling technique was used to select the public hospitals. All of the healthcare
providers who are supposed to be involved in the management of labor pain in the clustered hospitals were
included. Pretested structured questionnaires were used to collect data with regular supervision and follow
up. Data was entered in to epi info-7 and analyzed with SPSS-20 statistical software. Results were presented
using narratives, graphs, tables and charts. Conclusions were drawn by means of simple percentages and
inferential statistics using binary logistic regression, with P-value < 0.05 at 95% Confidence Interval (CI)
taken to be statistically significant.
Results: Of the 177 respondents, 81 (45.8 %) Anesthetists, 61 (34.5%) Midwives, 26 (14.7%)
Obstetricians/gynecologists, and 9 (5.1%) Anesthesiologists were involved. About 54.2% practitioners
offered any form of labor analgesia. Among these, only 1(0.6%) offered it routinely, 42 (23.7%) sometimes
and 53 (29.9%)on maternal request. Eighty-one respondents (45.8%) never practiced labor analgesia. The
commonest pharmacological labor analgesia used were opioids (35.6%). The major reasons adduced for
not offering labor analgesia routinely or not at all were; non-availability of drugs and equipment (59.9%),
lack of emphasis towards labor pain management by health service management system (44.1%), shortage
of skilled man power (38.4%), and fear of fetal distress to administer systemic analgesics (33.3%).
Conclusion and Recommendations: The routine practice of labor analgesia by healthcare providers was
very low in the study facilities. There is need for team work by all the stakeholders in the health sector and
the government to step up its use, and make childbirth a more fulfilling experience for laboring mothers.
Key words: labor, pain, analgesia, practice, barriers
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Keywords
Labor; Pain; Analgesia; Practice; Barriers