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Provision of essential evidence-based interventions during facility-based childbirth: cross-sectional observations of births in northeast Nigeria
OBJECTIVES: To measure the provision of evidence-based preventive and promotive interventions to women, and subsequently their newborns, during childbirth in a high-mortality setting. DESIGN AND PARTICIPANTS: Cross-sectional observations of care provided to women, and their newborns during the intra...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590366/ https://www.ncbi.nlm.nih.gov/pubmed/33099494 http://dx.doi.org/10.1136/bmjopen-2020-037625 |
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author | Exley, Josephine Hanson, Claudia Umar, Nasir Willey, Barbara Shuaibu, Abdulrahman Marchant, Tanya |
author_facet | Exley, Josephine Hanson, Claudia Umar, Nasir Willey, Barbara Shuaibu, Abdulrahman Marchant, Tanya |
author_sort | Exley, Josephine |
collection | PubMed |
description | OBJECTIVES: To measure the provision of evidence-based preventive and promotive interventions to women, and subsequently their newborns, during childbirth in a high-mortality setting. DESIGN AND PARTICIPANTS: Cross-sectional observations of care provided to women, and their newborns during the intrapartum and immediate postpartum period using a standardised checklist capturing healthcare worker behaviours regarding lifesaving and respectful care. SETTING: Ten primary healthcare facilities in Gombe state, northeast Nigeria. The northeast region of Nigeria has some of the highest maternal and newborn death rates globally. MAIN OUTCOME MEASURES: Data on 50 measures of internationally recommended evidence-based interventions and good practice. RESULTS: 1875 women were admitted to a health facility during the observation period; of these, 1804 gave birth in the facility and did not experience an adverse event or death. Many clinical interventions around the time of birth were routinely implemented, including provision of uterotonic (96% (95% CI 93% to 98%)), whereas risk-assessment measures, such as history-taking or checking vital signs were rarely completed: just 2% (95% CI 2% to 7%) of women had their temperature taken and 12% (95% CI 9% to 16%) were asked about complications during the pregnancy. CONCLUSIONS: The majority of women did not receive the recommended routine processes of childbirth care they and their newborns needed to benefit from their choice to deliver in a health facility. In particular, few benefited from even basic risk assessments, leading to missed opportunities to identify risks. To continue with the recommendation of childbirth care in primary healthcare facilities in high mortality settings like Gombe, it is crucial that birth attendant capacity, capability and prioritisation processes are addressed. |
format | Online Article Text |
id | pubmed-7590366 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-75903662020-11-03 Provision of essential evidence-based interventions during facility-based childbirth: cross-sectional observations of births in northeast Nigeria Exley, Josephine Hanson, Claudia Umar, Nasir Willey, Barbara Shuaibu, Abdulrahman Marchant, Tanya BMJ Open Health Services Research OBJECTIVES: To measure the provision of evidence-based preventive and promotive interventions to women, and subsequently their newborns, during childbirth in a high-mortality setting. DESIGN AND PARTICIPANTS: Cross-sectional observations of care provided to women, and their newborns during the intrapartum and immediate postpartum period using a standardised checklist capturing healthcare worker behaviours regarding lifesaving and respectful care. SETTING: Ten primary healthcare facilities in Gombe state, northeast Nigeria. The northeast region of Nigeria has some of the highest maternal and newborn death rates globally. MAIN OUTCOME MEASURES: Data on 50 measures of internationally recommended evidence-based interventions and good practice. RESULTS: 1875 women were admitted to a health facility during the observation period; of these, 1804 gave birth in the facility and did not experience an adverse event or death. Many clinical interventions around the time of birth were routinely implemented, including provision of uterotonic (96% (95% CI 93% to 98%)), whereas risk-assessment measures, such as history-taking or checking vital signs were rarely completed: just 2% (95% CI 2% to 7%) of women had their temperature taken and 12% (95% CI 9% to 16%) were asked about complications during the pregnancy. CONCLUSIONS: The majority of women did not receive the recommended routine processes of childbirth care they and their newborns needed to benefit from their choice to deliver in a health facility. In particular, few benefited from even basic risk assessments, leading to missed opportunities to identify risks. To continue with the recommendation of childbirth care in primary healthcare facilities in high mortality settings like Gombe, it is crucial that birth attendant capacity, capability and prioritisation processes are addressed. BMJ Publishing Group 2020-10-23 /pmc/articles/PMC7590366/ /pubmed/33099494 http://dx.doi.org/10.1136/bmjopen-2020-037625 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Health Services Research Exley, Josephine Hanson, Claudia Umar, Nasir Willey, Barbara Shuaibu, Abdulrahman Marchant, Tanya Provision of essential evidence-based interventions during facility-based childbirth: cross-sectional observations of births in northeast Nigeria |
title | Provision of essential evidence-based interventions during facility-based childbirth: cross-sectional observations of births in northeast Nigeria |
title_full | Provision of essential evidence-based interventions during facility-based childbirth: cross-sectional observations of births in northeast Nigeria |
title_fullStr | Provision of essential evidence-based interventions during facility-based childbirth: cross-sectional observations of births in northeast Nigeria |
title_full_unstemmed | Provision of essential evidence-based interventions during facility-based childbirth: cross-sectional observations of births in northeast Nigeria |
title_short | Provision of essential evidence-based interventions during facility-based childbirth: cross-sectional observations of births in northeast Nigeria |
title_sort | provision of essential evidence-based interventions during facility-based childbirth: cross-sectional observations of births in northeast nigeria |
topic | Health Services Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590366/ https://www.ncbi.nlm.nih.gov/pubmed/33099494 http://dx.doi.org/10.1136/bmjopen-2020-037625 |
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