Maternal Care

5 Pages 1146 Words

Enabling factors affecting the performance of skilled birth attendants

A wide variety of factors might affect the performance of skilled birth attendants, including provider competence and motivation, various patient characteristics, hospital leadership and supervision, availability of equipment, drugs and supplies, policies, time of day and week, and support team. This study examined the relationships between such factors and performance during labor, delivery and immediate postpartum maternal and newborn care. Data were obtained from 5 referral hospitals, 12 smaller hospitals, and 4 health centers in four countries (Benin, Ecuador, Jamaica, Rwanda). Performance was defined as compliance according to international standards and measured by direct observation of all births and retrospective record review of obstetric emergencies. The enabling factors were measured by a variety of instruments, measurements of the competency of birth attendants obtained from a related study.

Measuring competency of skilled birth attendants
This study developed instruments for measuring knowledge and skills of birth attendants. It was tested in four countries: Benin, Ecuador, Jamaica and Rwanda. The instruments measured competency during labor, delivery, postpartum maternal care, and postpartum newborn care. Knowledge was measured with a 55-item test derived from several well-known sources, such as the WHO IMPAC guidelines. The skills test included two partograph exercises and six skill stations using mannekins and attended by expert clinicians. Locally appropriate standards were added to the tests in each country.

Measuring in-facility delays during emergency obstetric care
This study developed and tested a method for measuring delays in the treatment of selected obstetrical emergencies within facilities in four countries: Benin, Ecuador, Jamaica, and Rwanda. Emergencies addressed included eclampsia/pre-eclampsia, sepsis, obstructed labor, post...