Volume 14, Issue 4 (Jul & Aug 2024)
J Research Health 2024, 14(4): 341-356 |
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Muwema M, Nankabirwa J I, Kaye D K, Nalwadda G, Nangendo J, Obeng-Amoako G O, et al . Structures and Available Processes to Support Perinatal Care in District Hospitals of Western Uganda. J Research Health 2024; 14 (4) :341-356
URL: http://jrh.gmu.ac.ir/article-1-2445-en.html
URL: http://jrh.gmu.ac.ir/article-1-2445-en.html
Structures and Available Processes to Support Perinatal Care in District Hospitals of Western Uganda
Mercy Muwema 
1, Joaniter I Nankabirwa2 , Dan K. Kaye3 , Gorrette Nalwadda4 , Joanita Nangendo2 , Gloria Odei Obeng-Amoako5 , Jean Claude Nkurunziza2 , Wilson Mwanja6 , Elizabeth N. Ekong7 , Robert Basaza8 , Joan N. Kalyango2 , Grace Edwards9
1, Joaniter I Nankabirwa2 , Dan K. Kaye3 , Gorrette Nalwadda4 , Joanita Nangendo2 , Gloria Odei Obeng-Amoako5 , Jean Claude Nkurunziza2 , Wilson Mwanja6 , Elizabeth N. Ekong7 , Robert Basaza8 , Joan N. Kalyango2 , Grace Edwards9
1- Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda. , muwecy@gmail.com
2- Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
3- Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
4- Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
5- Department of Nutrition and Food Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Legon, Ghana.
6- Whale Consult Limited, Kampala, Uganda.
7- Department of Nursing and Midwifery, Faculty of Public Health, Nursing and Midwifery, Uganda Christian University, Mukono, Uganda.
8- Department of Public Health, Faculty of Public Health, Nursing and Midwifery, Uganda Christian University, Mukono, Uganda.
9- Department of Midwifery, School of Nursing and Midwifery, Aga Khan University, Kampala, Uganda.
2- Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
3- Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
4- Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
5- Department of Nutrition and Food Science, School of Biological Sciences, College of Basic and Applied Sciences, University of Ghana, Legon, Ghana.
6- Whale Consult Limited, Kampala, Uganda.
7- Department of Nursing and Midwifery, Faculty of Public Health, Nursing and Midwifery, Uganda Christian University, Mukono, Uganda.
8- Department of Public Health, Faculty of Public Health, Nursing and Midwifery, Uganda Christian University, Mukono, Uganda.
9- Department of Midwifery, School of Nursing and Midwifery, Aga Khan University, Kampala, Uganda.
Abstract: (295 Views)
Background: To emphasize the essence of high-quality care in reducing maternal and neonatal mortality and morbidity, the World Health Organization (WHO) developed standards to support planners. This study describes the structures and care processes that were in place to support perinatal care provided to pregnant women at three district hospitals in Bunyoro region, Uganda using the WHO standards as a benchmark.
Methods: A cross-sectional study was conducted using pre-tested structured questionnaires and an observation checklist among 61 facility managers and healthcare providers working in perinatal units. The data were collected on structures that focused on staffing, basic equipment, essential medicines and supplies, diagnostic capacity, and basic amenities. In addition, data were collected on the following processes: Supervision of perinatal care, in-service training for perinatal healthcare providers, transition in care, coordination of care, and continuity of care. Descriptive analysis was used for all the data using the STATA software, version 13.
Results: Only 5 out of 18 doctors were designated to perinatal units. Each hospital had only one anesthetic officer. Two out of three of the hospitals did not have vital equipment in their postnatal units nor any communication equipment in all their perinatal units. No maternity unit had a designated waiting space for women in labor. The highest bed density for delivery and maternity beds was 6.6 per 1000 pregnant women. Refresher training was only offered once a year. Receiving units were not notified of the referral. Patient care records were paper-based using papers/exercise books as alternative documentation tools. Medications and laboratory or diagnostic findings were the least documented.
Conclusion: There is a shortage of critical human resources, equipment, and delivery and maternity beds. There were gaps in the communication of referrals and documentation of pregnant women’s care. The presence of a robust infrastructure, staffing, equipment, and medicines is critical in the provision of quality care to pregnant women.
Methods: A cross-sectional study was conducted using pre-tested structured questionnaires and an observation checklist among 61 facility managers and healthcare providers working in perinatal units. The data were collected on structures that focused on staffing, basic equipment, essential medicines and supplies, diagnostic capacity, and basic amenities. In addition, data were collected on the following processes: Supervision of perinatal care, in-service training for perinatal healthcare providers, transition in care, coordination of care, and continuity of care. Descriptive analysis was used for all the data using the STATA software, version 13.
Results: Only 5 out of 18 doctors were designated to perinatal units. Each hospital had only one anesthetic officer. Two out of three of the hospitals did not have vital equipment in their postnatal units nor any communication equipment in all their perinatal units. No maternity unit had a designated waiting space for women in labor. The highest bed density for delivery and maternity beds was 6.6 per 1000 pregnant women. Refresher training was only offered once a year. Receiving units were not notified of the referral. Patient care records were paper-based using papers/exercise books as alternative documentation tools. Medications and laboratory or diagnostic findings were the least documented.
Conclusion: There is a shortage of critical human resources, equipment, and delivery and maternity beds. There were gaps in the communication of referrals and documentation of pregnant women’s care. The presence of a robust infrastructure, staffing, equipment, and medicines is critical in the provision of quality care to pregnant women.
Keywords: Physical infrastructure, Staffing, Transition in care, Coordination of care, Continuity of care, Maternal health care
Type of Study: Orginal Article |
Subject:
● Service Quality
Received: 2023/10/14 | Accepted: 2024/01/8 | Published: 2024/07/1
Received: 2023/10/14 | Accepted: 2024/01/8 | Published: 2024/07/1
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