Introduction
Materials and methods
Study design, period, setting, and population
Sample size determination
Sampling technique and procedure
Variables
Dependent variable
Independent variables
Operational definitions
Data collection tool and procedure
Data quality control
Data processing and analysis
Result
Socio-demographic, primary care function, and facility level inputs characteristics of mothers
Variables | Frequency No | Percentage % |
---|---|---|
Age | ||
18–23 years | 34 | 15.7 |
24–29 years | 90 | 41.7 |
30–35 years | 76 | 35.2 |
≥ 36 years | 16 | 7.4 |
Educational status | ||
Unable to read and write | 121 | 56 |
Able to read and write | 30 | 13.9 |
Primary education | 24 | 11.1 |
Secondary education | 21 | 9.7 |
Diploma and above | 20 | 9.3 |
Number of children | ||
≤ 2 | 124 | 57.4 |
3–5 | 77 | 35.6 |
≥ 6 | 15 | 7.0 |
Cost for transportation to reach in health facility | ||
Not at all affordable | 33 | 15.3 |
Moderately affordable | 29 | 13.4 |
Affordable | 59 | 27.3 |
Free fee | 95 | 44 |
ANC follow-up with husband | ||
No | 95 | 44 |
Yes | 121 | 56 |
Type of health facility the care given | ||
Health center | 157 | 72.7 |
Hospital | 59 | 27.3 |
Respond to mothers politely an d respectfully | ||
Yes | 164 | 76 |
No | 52 | 24 |
Skin to skin mother—baby care | ||
Yes | 13 | 6 |
No | 203 | 94 |
Facility opening hour | ||
Not at all suitable | 26 | 12 |
Moderately suitable | 31 | 14.4 |
Suitable | 159 | 73.6 |
Transportation availability | ||
Difficult | 62 | 28.7 |
Moderately difficult | 38 | 17.6 |
Not at all difficult | 116 | 53.7 |
Distance from the health facility | ||
Long | 66 | 30.6 |
Quit long | 54 | 25 |
Short | 96 | 44.4 |
Use of partograph to follow the progress of labor | ||
Yes | 130 | 60.2 |
No | 86 | 39.8 |
Quality of intrapartum care
“Many mothers nowadays give birth in hospitals, even if their prior pregnancy was delivered at home. Although some mothers received some basic services, the majority of mothers received unsatisfactory health care. In general, the quality of care provided to mothers in this health center falls far short of what is expected’’(28 years male midwife).
“…. I was dissatisfied and unsure about the appropriateness of the service provided to me and my newborn since they were inattentive and lacked confidence” (Para 3, 32 years old mother).
‘‘….mostly we professionals are not updating ourselves with different guidelines, and the care which is given in this health center we can say it is not based on the standard. Therefore the hospital should mentor and correct the health centers. Health care providers at health centers and hospitals should receive various trainings so that they can improve their working processes. If such is the case, I believe mothers will receive better treatment"(24 years old midwife).
Factors associated with good quality of intrapartum care
‘‘The first problem I see in providing appropriate care to mothers is distance, especially in rural and remote places where neither an ambulance nor a motorcycle can reach them; as a result, mothers confront a challenge in receiving care” (health officer).
“Because of the distance, getting health care from health facilities has been difficult. We are from a distant rural area where we are unable to obtain adequate health care; therefore we have chosen to remain at home”.
“…mostly in our health center, we professionals do not use partograph during labor; the main reason is that most health workers do not have basic skill to use it”(Nurse).
Quality Intrapartum Care | |||||
---|---|---|---|---|---|
Variables | Good No. (%) | Poor No. (%) | COR (95%CI) | AOR (95%CI) | |
Distance from health facility | |||||
Long | 17 (25.8%) | 49 (74.2%) | 0.20 (0.08, 0.54) ** | 0.19 (0.06, 0.66) * | |
Quite long | 6 (11.1%) | 48 (88.9%) | 0.58 (0.29, 1.15) | 0.40 (0.12,1.11) | |
Short | 36 (37.5%) | 60 (62.5%) | 1 | 1 | |
Use of partograph to follow the progress of labor | |||||
Yes | 51 (39.2%) | 79 (60.8%) | 6.29 (2.81, 14.13) ** | 4.90 (1.82, 13.14) * | |
No | 8 (9.3) | 78 (90.7) | 1 | 1 | |
Type of health facility care given | |||||
Health center | 22 (14%) | 135 (86%) | 0.10 (0.05, 0.19) ** | 0.07 (0.02, 0.20) ** | |
Hospital | 37 (62.7%) | 22 (37.3%) | 1 | 1 | |
Mother came ANC follow-up with husband | |||||
Yes | 42 (34.7%) | 79 (65.3%) | 2.44 (1.28, 4.65) | 1.13 (0.47, 2.69) | |
No | 17 (17.9%) | 78 (82.1%) | 1 | 1 | |
Respond to mother politely and respectful manner | |||||
Yes | 52 (31.7%) | 112 (68.3%) | 2.99 (1.26, 7.06) | 1.69 (0.57, 5.03) | |
No | 7 (13.5%) | 45 (86.5%) | 1 | 1 | |
Skin to skin mother-baby care | |||||
Yes | 5 (38.5%) | 8(61.5%) | 1.72 (1.05, 4.23) | 1.13 (0.26, 2.83) | |
No | 54 (26.6%) | 149 (73.4%) | 1 | 1 | |
Facility’s opening hours | |||||
Not at all suitable | 3 (11.5%) | 23 (88.5%) | 0.45 (0.15, 0.85) | 0.23 (0.13, 1.12) | |
Moderately suitable | 7 (22.6%) | 24 (77.4%) | 0.65 (0.44, 11.52) | 0.31 (0.79, 7.21) | |
Suitable | 49 (30.8%) | 110 (69.2%) | 1 | 1 | |
Transport condition | |||||
Difficult | 6 (9.7%) | 56 (90.3%) | 0.23 (0.2, 0.87) | 0.14 (0.29, 2.79) | |
Moderately difficult | 12 (31.6%) | 26 (68.4%) | 0.84 (0.08, 0.53) | 0.48 (0.18, 3.36) | |
Not at all difficult | 41(35.3%) | 75 (64.7%) | 1 | 1 | |
Educational status of the mother | |||||
Unable to read & write | 22 (18.2%) | 99 (81.8%) | 0.44 (0.07, 0.98) | 0.21 (0.73, 2.31) | |
Able to read & write | 10 (33.3%) | 20 (66.7%) | 0.83 (0.12, 1.4) | 0.46 (0.8, 2.45) | |
Primary education | 9 (37.5%0 | 25 (62.5%) | 0.87 (0.1, 1.1) | 0.50 (0.5, 2.13) | |
Secondary education | 6 (28.6) | 15 (71.4%) | 0.90 (0.05, 0.41) | 0.53 (0.47, 2.69) | |
Diploma and above | 12 (60%) | 8 (40%) | 1 | 1 |
‘‘We asked the administrative bodies to increase duty staff for improving the quality of care, but still no response. Since one person was in duty, we face difficulty in utilizing the patrograph appropriately, so quality affected’’(Midwife).