Developing strategies to improve the quality of facility based care during labour and childbirth
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Date
2023
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University of the Western Cape
Abstract
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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Keywords
Labour and childbirth, Neonatal mortality, Northeast Namibia, Perinatal deaths, Quality-of-care