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Barriers to providing quality emergency obstetric care in Addis Ababa, Ethiopia: Healthcare providers' perspectives on training, referrals and supervision, a mixed methods study.

Authors :
Austin A
Gulema H
Belizan M
Colaci DS
Kendall T
Tebeka M
Hailemariam M
Bekele D
Tadesse L
Berhane Y
Langer A
Source :
BMC pregnancy and childbirth [BMC Pregnancy Childbirth] 2015 Mar 29; Vol. 15, pp. 74. Date of Electronic Publication: 2015 Mar 29.
Publication Year :
2015

Abstract

Background: Increasing women's access to and use of facilities for childbirth is a critical national strategy to improve maternal health outcomes in Ethiopia; however coverage alone is not enough as the quality of emergency obstetric services affects maternal mortality and morbidity. Addis Ababa has a much higher proportion of facility-based births (82%) than the national average (11%), but timely provision of quality emergency obstetric care remains a significant challenge for reducing maternal mortality and improving maternal health. The purpose of this study was to assess barriers to the provision of emergency obstetric care in Addis Ababa from the perspective of healthcare providers by analyzing three factors: implementation of national referral guidelines, staff training, and staff supervision.<br />Methods: A mixed methods approach was used to assess barriers to quality emergency obstetric care. Qualitative analyses included twenty-nine, semi-structured, key informant interviews with providers from an urban referral network consisting of a hospital and seven health centers. Quantitative survey data were collected from 111 providers, 80% (111/138) of those providing maternal health services in the same referral network.<br />Results: Respondents identified a lack of transportation and communication infrastructure, overcrowding at the referral hospital, insufficient pre-service and in-service training, and absence of supportive supervision as key barriers to provision of quality emergency obstetric care.<br />Conclusions: Dedicated transportation and communication infrastructure, improvements in pre-service and in-service training, and supportive supervision are needed to maximize the effective use of existing human resources and infrastructure, thus increasing access to and the provision of timely, high quality emergency obstetric care in Addis Ababa, Ethiopia.

Details

Language :
English
ISSN :
1471-2393
Volume :
15
Database :
MEDLINE
Journal :
BMC pregnancy and childbirth
Publication Type :
Academic Journal
Accession number :
25885336
Full Text :
https://doi.org/10.1186/s12884-015-0493-4