Back to Search
Start Over
Beneath the Surface: A Comparison of Methods for Assessment of Quality of Care for Maternal and Neonatal Health Care in Rural Uganda.
- Source :
-
Maternal and child health journal [Matern Child Health J] 2020 Mar; Vol. 24 (3), pp. 328-339. - Publication Year :
- 2020
-
Abstract
- Objectives: Efforts to improve access to healthcare in low-income countries will not achieve the maternal and child health (MCH) Sustainable Development Goals unless a concomitant improvement in the quality of care (QoC) occurs. This study measures infrastructure and QoC indicators in rural Ugandan health facilities. Valid measure of the quality of current clinical practices in resource-limited settings are critical for effectively intervening to reduce adverse maternal and neonatal outcomes.<br />Methods: Facility-based assessments of infrastructure and clinical quality during labor and delivery were conducted in six primary care health facilities in the greater Masaka area, Uganda in 2017. Data were collected using direct observation of clinical encounters and facility checklists. Direct observation comprised the entire delivery process, from initial client assessment to discharge, and included emergency management (e.g. postpartum hemorrhage, neonatal resuscitation). Health providers were assessed on their adherence to best practice standards of care.<br />Results: The quality of facility infrastructure was relatively high in facilities, with little variation in availability of equipment and supplies. However, heterogeneity in adherence to best clinical practices was noted across procedure type and facility. Adherence to crude measures of clinical quality were relatively high but more sensitive measures of the same clinical practice were found to be much lower.<br />Conclusions for Practice: Standard indicators of clinical practice may be insufficient to validly measure clinical quality for maternal and newborn care if we want to document evidence of impact.
- Subjects :
- Female
Health Services Accessibility
Humans
Infant Health
Pregnancy
Pregnancy Complications epidemiology
Quality of Health Care
Rural Health Services
Rural Population
Uganda epidemiology
Health Facilities standards
Maternal-Child Health Services standards
Patient Safety statistics & numerical data
Quality Indicators, Health Care statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1573-6628
- Volume :
- 24
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Maternal and child health journal
- Publication Type :
- Academic Journal
- Accession number :
- 31894511
- Full Text :
- https://doi.org/10.1007/s10995-019-02862-w