ASSESSMENT OF QUALITY OF MIDWIVES’ INTRAPARTUM CARE AND WOMEN SATISFACTION IN SECONDARY HEALTHCARE FACILITIES IN MAIDUGURI METROPOLIS, BORNO STATE NIGERIA

ASSESSMENT OF QUALITY OF MIDWIVES’ INTRAPARTUM CARE AND WOMEN SATISFACTION IN SECONDARY HEALTHCARE FACILITIES IN MAIDUGURI METROPOLIS, BORNO STATE NIGERIA

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ABSTRACT

Majority of the high maternal morbidities and mortalities in sub-Saharan Africa occur around the intrapartum period. These morbidities and mortalities although unpredictable, are treatable when diagnoses are made early and appropriate treatments are given. The aim of this study was to assess the quality of midwives‘ intrapartum care and women satisfaction in secondary healthcare facilities in Maiduguri metropolis, Borno state Nigeria. Five objectives were stated; to assess the available human resources (midwives) for intrapartum care, to assess the available material resources for intrapartum care, to assess the level of knowledge of midwives on intrapartum care, to assess the level of practice of midwives on intrapartum care and to assess the level of women satisfaction with intrapartum care. Donabedian framework was adopted for this study. A cross sectional descriptive research design was adopted for the study. Three secondary healthcare facilities in Maiduguri Metropolis were selected for data collection and a total of 43 midwives and 240 women were recruited in the study with response rate of 95%, 81% and 100% for knowledge, practice and satisfaction respectively. All the midwives were used for the study and convenient sampling technique was used to select the women for the study. Five tools were used for data collection, all privacy and confidentiality was maintained during the work and the data was collected from August to November, 2017.Results revealed that the mean age of the midwives was 35.2 years and 28.7 years for the women. The human resources were available but inadequate and material resources were available (42%) but inadequate for intrapartum care. According to the midwives‘ level of knowledge on intrapartum care, majority (78%) of the midwives have high level of knowledge. With regards their level of practice, 53.9% of the midwives‘ demonstrated high level of practice and 64.4% of the women were satisfied with the level of care during the intrapartum period with a mean of 2.4/4. Based on the findings, it can be concluded that the human resources and material resources were available but inadequate, midwives level of knowledge was high with good level of practice and women were satisfied. It was recommended that adequate human and material resources should be provided by the government to meet the ever increasing demands of the population and adequate in-service training for midwives to upgrade the techniques necessary to assess, evaluate and improve the quality of care rendered to women in labour.

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Sustainable development goals are a universal call to action to end poverty, protect the planet

and ensure that all people enjoy peace and prosperity. It is composed of seventeen goals.

Goal three is to ensure healthy lives and promote well-being for all at all ages and the target

is to reduce global maternal mortality ratio to less than 70 per 100,000 live births. The goal

addresses all major health priorities including maternal and child health. It calls for more

research and development, increased health financing and strengthened capacity of all

countries in health risk reduction and management (United Nations (UN), 2016).

Every year about 287,000 women die of causes associated with childbirth (Srivastava, Avan,

Rajbangshi and Bhattacharyya, 2015). Nigeria constitutes 1.7% of the world population and

contributes 10% of the global burden of maternal deaths. Majority of the deaths occur around

the delivery period (Igwebueze, 2015). The estimated maternal mortality is 576 per 100,000

live births (Nigeria Demographic and Health Survey (NDHS), 2013). And according to

World Health Organization (WHO, 2015) Nigeria‘s maternal mortality is 814 per 100,000

live births. Northern Nigeria has the highest burden of maternal mortality in the country, with

North east having the highest burden. Borno, out of the 19 northern states accounts for 20.6%

of maternal deaths with maternal mortality ratio of 921/100,000 live births (National Primary

Health Care Development Agency (NPHCDA) Report, 2014).

Quality is the degree to which maternal health services for individuals and populations

increase the likelihood of timely and appropriate treatment for the purpose of achieving

desired outcomes that are both consistent with current professional knowledge and uphold

basic reproductive rights (Austin, Langer, Salam,Lassi, Das, and Bhutta, 2014). The elements

of quality are accessibility, effectiveness, essential provision of supplies and equipments,

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quality of client provider's interaction, equity, acceptability, comprehensiveness of care,

continuity of care and follow up and support to healthcare providers (Abdallah, Elsabagh and

El Wady, 2012). Quality of maternity care services means providing a minimum level of care

to all pregnant women and their babies; obtaining the best possible outcome, maintaining

sound managerial and financial performance. Also includes developing existing services in


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