Browsing by Author "Siseho, Gloria Mutimbwa"

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    Baseline assessment of the WHO/UNICEF/UNFPA maternal and newborn quality-of-care standards around childbirth: Results from an intermediate hospital, northeast Namibia
    (Frontiers Media S.A., 2023) Siseho, Gloria Mutimbwa; Mathole, Thubelihle; Debra, Jackson
    Background: Quality of care around childbirth can reduce above half of the stillbirths and newborn deaths. Northeast Namibia’s neonatal mortality is higher than the national level. Yet, no review exists on the quality of care provided around childbirth. This paper reports on baseline assessment for implementing WHO/UNICEF/UNFPA quality measures around childbirth. Methods: A mixed-methods research design was used to assess quality of care around childbirth. To obtain good saturation and adequate women opinions, we purposively sampled the only high-volume hospital in northeast Namibia; observed 53 women at admission, of which 19 progressed to deliver on the same day/hours of data collection; and interviewed 20 staff and 100 women who were discharged after delivery. The sampled hospital accounted for half of all deliveries in that region and had a high (27/1,000) neonatal mortality rate above the national (20/1,000) level. We systematically sampled every 22nd delivery until the 259 mother–baby pair was reached. Data were collected using the Every Mother Every Newborn assessment tool, entered, and analyzed using SPSS V.27. Descriptive statistics was used, and results were summarized into tables and graphs. Results: We reviewed 259 mother–baby pair records. Blood pressure, pulse, and temperature measurements were done in 98% of observed women and 90% of interviewed women at discharge. Above 80% of human and essential physical resources were adequately available. Gaps were identified within the WHO/UNICEF/UNFPA quality standard 1, a quality statement on routine postpartum and postnatal newborn care (1.1c), and also within standards 4, 5, and 6 on provider–client interactions (4.1), information sharing (5.3), and companionship (6.1). Only 45% of staff received in-service training/refresher on postnatal care and breastfeeding. Most mothers were not informed about breastfeeding (52%), postpartum care and hygiene (59%), and family planning (72%). On average, 49% of newborn postnatal care interventions (1.1c) were practiced. Few mothers (0–12%) could mention any newborn danger signs. Conclusion: This is the first study in Namibia to assess WHO/UNICEF/UNFPA quality-of-care measures around childbirth. Measurement of provider–client interactions and information sharing revealed significant deficiencies in this aspect of care that negatively affected the client’s experience of care. To achieve reductions in neonatal death, improved training in communication skills to educate clients is likely to have a major positive and relatively low-cost impact.
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    Developing strategies to improve the quality of facility based care during labour and childbirth
    (University of the Western Cape, 2023) Siseho, Gloria Mutimbwa; Mathole, Thubelihle
    Introduction: Globally, 50% of maternal and 60% of newborn deaths are due to poor quality-of-care or are preventable by the health system. According to the 2013 Namibia Demographic Health Survey (NDHS), northeast Namibia’s neonatal mortality rate is higher (27/1 000 live births) than the national (20/1 000 live births) level; with 47.7% of mothers and only =3% of neonates received postnatal care within 48 hours. Yet, no quality-of-care assessment existed to determine the quality of services provided to women and newborns during labour and childbirth, and in the immediate postnatal care. Neither was a maternal and newborn quality improvement programme implemented before this PhD research. The research aimed to implement strategic interventions for improving the quality of facility-based care during labour and childbirth. Methods: The study was conducted in a regional referral hospital, northeast Namibia using mixed methods of quantitative and qualitative survey. The qualitative data was not analysed by time of this thesis submission, thus will not be part of the thesis report. The hospital service three district hospitals, and one region with one district, far northeast of Namibia. This research used a pre-post study design because it was neither randomisation nor the use of a control group. The Every Mother Every Newborn (EMEN) quantitative survey questionnaire or assessment tools were used to collect data by interviewing the facility manager, nurses and doctors working with pregnant women in labour and delivery and postnatal care units, and women who gave birth at their time of discharge before going home.
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    Monitoring healthcare improvement for mothers and newborns: A quantitative review of WHO/UNICEF/UNFPA standards using every mother every mewborn assessment tools
    (Frontiers Media, 2022) Siseho, Gloria Mutimbwa; Mathole, Thubelihle; Jackson, Debra
    Assessment tools with the ability to capture WHO/UNICEF/UNFPA standard quality-of-care measures are needed. This study aimed to assess the ability of Every Mother Every Newborn (EMEN) tools to capture WHO/UNICEF/UNFPA maternal and newborn quality improvement standard indicators. A quantitative study using the EMEN quality assessment framework was applied. The six EMEN tools were compared with the WHO/UNICEF/UNFPA maternal and newborn quality improvement standards. Descriptive statistics analysis was carried out with summaries using tables and figures.