22 March 2012
International evidence suggests that improving the quality of obstetric care and reducing maternal and neonatal deaths necessitates having accurate and reliable data on the quality of related health services. With support from USAID, MCHIP partnered with Ethiopia’s Federal Ministry of Health to gather such information in March and April of 2010.
A final report—entitled Quality of Care for Prevention and Management of Common Maternal and Newborn Complications: A Study of Ethiopia’s Hospitals—reveals the results of examining the quality of care (QoC) of maternal and newborn health services during antenatal and delivery care in Ethiopia. The survey was fielded in the 19 Ethiopian hospitals with the heaviest volume of deliveries, and is one of a series of MCHIP maternal and newborn QoC reports to be released in a multi-country study.
The primary objective of the survey in Ethiopia was to determine the frequency and quality of interventions that address the direct causes of maternal and neonatal deaths, and to guide the need for and content of QoC improvement activities for maternal and newborn care at hospitals. The results are itended to be used to inform and guide the national program and policies responsible for quality improvement in antenatal care, labor and delivery, and immediate newborn care.
The study involved observations of 126 antenatal care consultations and 192 deliveries, and interviews with 79 health workers (antenatal care providers and labor and delivery providers), plus an inventory of supplies, equipment and infrastructure at each facility.
Key findings include:
Postpartum hemorrhage (PPH)
Postpartum sepsis in mother and newborn
Conclusions and Recommendations
Overall, the QoC observed during the study was often below internationally accepted standards for antenatal care, labor and delivery practices, and essential newborn care. The study findings reveal a need to further integrate evidence-based practices and quality assurance processes at all hospital levels.
Furthermore, a concerted countrywide drive to improve the quality of maternal and newborn care is needed, and it should include implementing routine clinical and quality audits with attendant feedback mechanisms, retraining and supportive supervision, and making the FMOH’s Management Protocol on Selected Obstetrics Topics widely available. Such an effort will enhance the the capacity of health workers to provide the signal functions for basic and comprehensive emergency obstetric care and, consequently, to help to reduce maternal and newborn mortality and achieve Ethiopia’s targets for Millennium Development Goals 4 and 5.