About: Quality of intrapartum care: direct observations in a low-resource tertiary hospital

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About: Quality of intrapartum care: direct observations in a low-resource tertiary hospital Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Quality of intrapartum care: direct observations in a low-resource tertiary hospital
Creator	Grobbee, Diederick Rijken, Marcus Housseine, Natasha Maaløe, Nanna Browne, Joyce Franx, Arie Meguid, Tarek Punt, Marieke Said, Said Gharib Mohamed, Ali Nicolaas, P Zuithoff,
Source	PMC
abstract	BACKGROUND: The majority of the world’s perinatal deaths occur in low- and middle-income countries. A substantial proportion occurs intrapartum and is avoidable with better care. At a low-resource tertiary hospital, this study assessed the quality of intrapartum care and adherence to locally-tailored clinical guidelines. METHODS: A non-participatory, structured, direct observation study was held at Mnazi Mmoja Hospital, Zanzibar, Tanzania, between October and November 2016. Women in active labour were followed and structure, processes of labour care and outcomes of care systematically recorded. Descriptive analyses were performed on the labour observations and compared to local guidelines and supplemented by qualitative findings. A Poisson regression analysis assessed factors affecting foetal heart rate monitoring (FHRM) guidelines adherence. RESULTS: 161 labouring women were observed. The nurse/midwife-to-labouring-women ratio of 1:4, resulted in doctors providing a significant part of intrapartum monitoring. Care during labour and two-thirds of deliveries was provided in a one-room labour ward with shared beds. Screening for privacy and communication of examination findings were done in 50 and 34%, respectively. For the majority, there was delayed recognition of labour progress and insufficient support in second stage of labour. While FHRM was generally performed suboptimally with a median interval of 105 (interquartile range 57–160) minutes, occurrence of an intrapartum risk event (non-reassuring FHR, oxytocin use or poor progress) increased assessment frequency significantly (rate ratio 1.32 (CI 1.09–1.58)). CONCLUSIONS: Neither international nor locally-adapted standards of intrapartum routine care were optimally achieved. This was most likely due to a grossly inadequate capacity of birth attendants; without whom innovative interventions at birth are unlikely to succeed. This calls for international and local stakeholders to address the root causes of unsafe intrafacility care in low-resource settings, including the number of skilled birth attendants required for safe and respectful births.
has issue date	2020-03-14(xsd:dateTime)
bibo:doi	10.1186/s12978-020-0849-8
bibo:pmid	32171296
has license	cc-by
sha1sum (hex)	e8fd268440c635ff87da4ae1c7b8e66898bf92b8
schema:url	https://doi.org/10.1186/s12978-020-0849-8
resource representing a document's title	Quality of intrapartum care: direct observations in a low-resource tertiary hospital
has PubMed Central identifier	PMC7071714
has PubMed identifier	32171296
schema:publication	Reprod Health
resource representing a document's body	covid:e8fd268440c635ff87da4ae1c7b8e66898bf92b8#body_text
is schema:about of	named entity 'oxytocin' named entity 'birth attendants' named entity 'perinatal' named entity 'observation' named entity 'Zanzibar' named entity 'BACKGROUND' named entity 'REGRESSION ANALYSIS' named entity 'LABOUR OBSERVATIONS' named entity 'ADDRESS' named entity 'RATIO' named entity 'GUIDELINES ' named entity 'BEDS' named entity 'MEDIAN' named entity 'RISK' named entity 'SHARED' named entity 'HELD' named entity 'QUALITY' named entity 'INTRAPARTUM' named entity 'LOW' named entity 'heart rate' named entity 'birth attendants' named entity 'settings' named entity 'Screening' named entity 'care' named entity 'monitoring' named entity 'Descriptive' named entity 'majority' named entity 'For' named entity 'active' named entity 'event' named entity 'November' named entity 'ratio' named entity 'local' named entity 'number' named entity 'clinical guidelines' named entity 'systematically' named entity 'study' named entity 'nurse' named entity 'substantial' named entity 'Poisson regression' named entity 'Tanzania' named entity 'optimally' named entity 'nurse-midwife' named entity 'stillbirths' named entity 'labour ward' named entity 'supportive care' named entity 'foetal' named entity 'stillbirths' named entity 'birth asphyxia' named entity 'Apgar score' named entity 'birth outcomes' named entity 'Skilled birth attendants' named entity 'Tanzania' named entity 'medical student' named entity 'midwife' named entity 'Sub-Saharan Africa' named entity 'obstetric' named entity 'SBAs' named entity 'p-values' named entity 'United Republic of Tanzania' named entity 'labour ward' named entity 'heart rate' named entity 'ultrasound' named entity 'Sub-Saharan Africa' named entity 'labour ward' named entity 'risk ratio' named entity 'Skilled birth attendants' named entity 'abdomen' named entity 'stillbirth' named entity 'evidence-based'

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