Assessment of quality of midwifery care during labour at maternity departments of intermediate and refferral hospitals in Namibia
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Date
2021
Authors
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Publisher
University of Namibia
Abstract
Quality of midwifery care can be defined as care delivered by midwives, which is safe, effective, efficient, accessible, acceptable, patient-centred, equitable, and results in a positive pregnancy outcome. This research aims to assess the quality of midwifery care rendered during labour at the intermediate and referral hospital in Namibia. In Namibia, the Ministry of Health and Social Services (MoHSS) in particular, has come up with many interventions aiming to reduce maternal and neonatal mortality and morbidity. Even though these programmes were implemented, the programme reviews conducted by MoHSS in 2016 identified some gaps in the quality of midwifery care and recommended the conduct of a second nationwide Emergency Obstetric and Neonatal Care (EmONC) assessment.
The main objectives of this study therefore were to describe the demographic profile, conclude the standard of midwifery care rendered during the first, second, third and fourth stages of labour by reviewing maternity records and analysing the standard of midwifery care rendered during the first, second, third and fourth stages of labour of the women who gave birth at intermediate and referral hospital from 01 January to 31 March 2018. The study was a retrospective study with a descriptive quantitative design conducted on 653 maternity records at the above mentioned hospitals. The findings revealed the age group from twenty to thirty-five to be the highest age group that gave birth i.e. (78.6%), while (10.7%) were adolescents and (10.7%) of the women aged above 36 years of age. This study indicated that (95%) of these women attended antenatal care. However, obstetric history indicates that the majority of the women who had delivered 391 (59.9 %), had two to four children, followed by those who gave birth for the first time 197 (30.2 %), while the lowest were those who had five or more children 65 (10.0%). Early opening of a partograph could lead to early identification of problems and plans for interventions. This study further shows that 402 (61.6%) partographs were mostly opened with women in the active phase of labour. Few partographs 33 (5.1%) were opened in the latent phase of labour. However, partographs that were opened, the study results revealed that not all were managed according to the WHO guidelines. Poor documentation of midwifery interventions and care was noted, suggesting poor midwifery care. Most of the deliveries 499 (76.4%) were normal vaginal deliveries, followed by 151 (23.1%) who had caesarean section deliveries. The rest had assisted deliveries with one breech delivery. According to the findings of this study it can be concluded that midwifery care rendered during labour at the studied hospitals was of substandard.
Description
A research thesis submitted in partial fulfillment of the requirements for the Degree of Master in Nursing Science
Keywords
Midwifery care, Maternal labour