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Knowledge on intrapartum care practices among skilled birth attendants in Cambodia—a cross-sectional study

BACKGROUND: Delivery is a critical moment for pregnant women and babies, and careful monitoring is essential throughout the delivery process. The partograph is a useful tool for monitoring and assessing labour progress as well as maternal and foetal conditions; however, it is often used inaccurately...

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Autores principales: Matsui, Mitsuaki, Saito, Yuko, Po, Rithy, Taing, Bunsreng, Nhek, Chamnan, Tung, Rathavy, Masaki, Yoko, Iwamoto, Azusa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191061/
https://www.ncbi.nlm.nih.gov/pubmed/34108001
http://dx.doi.org/10.1186/s12978-021-01166-z
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author Matsui, Mitsuaki
Saito, Yuko
Po, Rithy
Taing, Bunsreng
Nhek, Chamnan
Tung, Rathavy
Masaki, Yoko
Iwamoto, Azusa
author_facet Matsui, Mitsuaki
Saito, Yuko
Po, Rithy
Taing, Bunsreng
Nhek, Chamnan
Tung, Rathavy
Masaki, Yoko
Iwamoto, Azusa
author_sort Matsui, Mitsuaki
collection PubMed
description BACKGROUND: Delivery is a critical moment for pregnant women and babies, and careful monitoring is essential throughout the delivery process. The partograph is a useful tool for monitoring and assessing labour progress as well as maternal and foetal conditions; however, it is often used inaccurately or inappropriately. A gap between practices and evidence-based guidelines has been reported in Cambodia, perhaps due to a lack of evidence-based knowledge in maternity care. This study aims to address to what extent skilled birth attendants in the first-line health services in Cambodia have knowledge on the management of normal delivery, and what factors are associated with their level of knowledge. METHODS: Midwives and nurses were recruited working in maternity in first-line public health facilities in Phnom Penh municipality, Kampong Cham and Svay Rieng provinces. Two self-administered questionnaires were applied. The first consisted of three sections with questions on monitoring aspects of the partograph: progress of labour, foetal, and maternal conditions. The second consisted of questions on diagnostic criteria, normal ranges, and standard intervals of monitoring during labour. A multiple linear regression analysis was performed to identify relationships between characteristics of the participants and the questionnaire scores. RESULTS: Of 542 eligible midwives and nurses, 523 (96%) participated. The overall mean score was 58%. Only 3% got scores of more than 90%. Multivariate analysis revealed that ‘Kampong Cham province’, ‘younger age’, and ‘higher qualification’ were significantly associated with higher scores. Previous training experience was not associated with the score. Substantial proportions of misclassification of monitoring items during labour were found; for example, 61% answered uterine contraction as a foetal condition, and 44% answered foetal head descent and 26% answered foetal heart rate as a maternal condition. CONCLUSION: This study found that knowledge was low on delivery management among skilled birth attendants. Previous training experience did not influence the knowledge level. A lack of understanding of physiology and anatomy was implied. Further experimental approaches should be attempted to improve the knowledge and quality of maternity services in Cambodia. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12978-021-01166-z.
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spelling pubmed-81910612021-06-10 Knowledge on intrapartum care practices among skilled birth attendants in Cambodia—a cross-sectional study Matsui, Mitsuaki Saito, Yuko Po, Rithy Taing, Bunsreng Nhek, Chamnan Tung, Rathavy Masaki, Yoko Iwamoto, Azusa Reprod Health Research BACKGROUND: Delivery is a critical moment for pregnant women and babies, and careful monitoring is essential throughout the delivery process. The partograph is a useful tool for monitoring and assessing labour progress as well as maternal and foetal conditions; however, it is often used inaccurately or inappropriately. A gap between practices and evidence-based guidelines has been reported in Cambodia, perhaps due to a lack of evidence-based knowledge in maternity care. This study aims to address to what extent skilled birth attendants in the first-line health services in Cambodia have knowledge on the management of normal delivery, and what factors are associated with their level of knowledge. METHODS: Midwives and nurses were recruited working in maternity in first-line public health facilities in Phnom Penh municipality, Kampong Cham and Svay Rieng provinces. Two self-administered questionnaires were applied. The first consisted of three sections with questions on monitoring aspects of the partograph: progress of labour, foetal, and maternal conditions. The second consisted of questions on diagnostic criteria, normal ranges, and standard intervals of monitoring during labour. A multiple linear regression analysis was performed to identify relationships between characteristics of the participants and the questionnaire scores. RESULTS: Of 542 eligible midwives and nurses, 523 (96%) participated. The overall mean score was 58%. Only 3% got scores of more than 90%. Multivariate analysis revealed that ‘Kampong Cham province’, ‘younger age’, and ‘higher qualification’ were significantly associated with higher scores. Previous training experience was not associated with the score. Substantial proportions of misclassification of monitoring items during labour were found; for example, 61% answered uterine contraction as a foetal condition, and 44% answered foetal head descent and 26% answered foetal heart rate as a maternal condition. CONCLUSION: This study found that knowledge was low on delivery management among skilled birth attendants. Previous training experience did not influence the knowledge level. A lack of understanding of physiology and anatomy was implied. Further experimental approaches should be attempted to improve the knowledge and quality of maternity services in Cambodia. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12978-021-01166-z. BioMed Central 2021-06-09 /pmc/articles/PMC8191061/ /pubmed/34108001 http://dx.doi.org/10.1186/s12978-021-01166-z Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Matsui, Mitsuaki
Saito, Yuko
Po, Rithy
Taing, Bunsreng
Nhek, Chamnan
Tung, Rathavy
Masaki, Yoko
Iwamoto, Azusa
Knowledge on intrapartum care practices among skilled birth attendants in Cambodia—a cross-sectional study
title Knowledge on intrapartum care practices among skilled birth attendants in Cambodia—a cross-sectional study
title_full Knowledge on intrapartum care practices among skilled birth attendants in Cambodia—a cross-sectional study
title_fullStr Knowledge on intrapartum care practices among skilled birth attendants in Cambodia—a cross-sectional study
title_full_unstemmed Knowledge on intrapartum care practices among skilled birth attendants in Cambodia—a cross-sectional study
title_short Knowledge on intrapartum care practices among skilled birth attendants in Cambodia—a cross-sectional study
title_sort knowledge on intrapartum care practices among skilled birth attendants in cambodia—a cross-sectional study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191061/
https://www.ncbi.nlm.nih.gov/pubmed/34108001
http://dx.doi.org/10.1186/s12978-021-01166-z
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