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Quality and timeliness of emergency obstetric care and its association with maternal outcome in Keren Hospital, Eritrea
Despite the critical role quality comprehensive emergency obstetric care (CEmOC) plays in ensuring safe motherhood, only a few studies have attempted to measure the impact of substandard and delayed care on maternal outcome thus far. This study evaluates the association between various process and t...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9418268/ https://www.ncbi.nlm.nih.gov/pubmed/36028743 http://dx.doi.org/10.1038/s41598-022-18685-9 |
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author | Zewde, Henos Kiflom |
author_facet | Zewde, Henos Kiflom |
author_sort | Zewde, Henos Kiflom |
collection | PubMed |
description | Despite the critical role quality comprehensive emergency obstetric care (CEmOC) plays in ensuring safe motherhood, only a few studies have attempted to measure the impact of substandard and delayed care on maternal outcome thus far. This study evaluates the association between various process and timeliness indicators of CEmOC and adverse maternal outcome in Keren Hospital. This study compared women with potentially life-threatening condition (PLTC) and women with severe maternal outcome (SMO) with respect to various process and timeliness indicators. Logistic regression analysis was employed to assess the association of timeliness and process indicators with SMO using SPSS version-22 computer software. In this study, we included 491 cases of PLTC and 210 cases of SMO (171 maternal near misses and 39 maternal deaths). The following process indicators showed significant association with SMO: failure to give uterotonics for the treatment of postpartum hemorrhage, failure to administer prophylactic antibiotics, and delayed laporatomy for uterine rupture. Moreover, delays in referral, triaging, seeing an obstetrician, and receiving definitive treatement were strongly associated with SMO. The following causes of delay were also found to be independently associated with SMO: erroneous diagnosis, inappropriate management, multiple referrals between health facilities, unavailability of a senior obstetrician, and poor communication during referral. Among the miscellaneous factors, nighttime admission and referral during the rainy season showed significant association with SMO. Findings of this study indicate that huge gap exists in providing quality and timely care in Keren Hospital. In general, most incidents of substandard and delayed care were due to poor referral system, insufficiency of medical staff, inadequacy of drugs and equipment, and unavailability of standard management protocol. Improving the referral system, upgrading the technical skills of health professionals, making sure life-saving drugs and equipment are available all the time, and posting standard treatment and management protocols in the maternity and emergency rooms will play a vital role in reducing the occurrence of SMO in Keren Hospital. |
format | Online Article Text |
id | pubmed-9418268 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-94182682022-08-28 Quality and timeliness of emergency obstetric care and its association with maternal outcome in Keren Hospital, Eritrea Zewde, Henos Kiflom Sci Rep Article Despite the critical role quality comprehensive emergency obstetric care (CEmOC) plays in ensuring safe motherhood, only a few studies have attempted to measure the impact of substandard and delayed care on maternal outcome thus far. This study evaluates the association between various process and timeliness indicators of CEmOC and adverse maternal outcome in Keren Hospital. This study compared women with potentially life-threatening condition (PLTC) and women with severe maternal outcome (SMO) with respect to various process and timeliness indicators. Logistic regression analysis was employed to assess the association of timeliness and process indicators with SMO using SPSS version-22 computer software. In this study, we included 491 cases of PLTC and 210 cases of SMO (171 maternal near misses and 39 maternal deaths). The following process indicators showed significant association with SMO: failure to give uterotonics for the treatment of postpartum hemorrhage, failure to administer prophylactic antibiotics, and delayed laporatomy for uterine rupture. Moreover, delays in referral, triaging, seeing an obstetrician, and receiving definitive treatement were strongly associated with SMO. The following causes of delay were also found to be independently associated with SMO: erroneous diagnosis, inappropriate management, multiple referrals between health facilities, unavailability of a senior obstetrician, and poor communication during referral. Among the miscellaneous factors, nighttime admission and referral during the rainy season showed significant association with SMO. Findings of this study indicate that huge gap exists in providing quality and timely care in Keren Hospital. In general, most incidents of substandard and delayed care were due to poor referral system, insufficiency of medical staff, inadequacy of drugs and equipment, and unavailability of standard management protocol. Improving the referral system, upgrading the technical skills of health professionals, making sure life-saving drugs and equipment are available all the time, and posting standard treatment and management protocols in the maternity and emergency rooms will play a vital role in reducing the occurrence of SMO in Keren Hospital. Nature Publishing Group UK 2022-08-26 /pmc/articles/PMC9418268/ /pubmed/36028743 http://dx.doi.org/10.1038/s41598-022-18685-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This 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/) . |
spellingShingle | Article Zewde, Henos Kiflom Quality and timeliness of emergency obstetric care and its association with maternal outcome in Keren Hospital, Eritrea |
title | Quality and timeliness of emergency obstetric care and its association with maternal outcome in Keren Hospital, Eritrea |
title_full | Quality and timeliness of emergency obstetric care and its association with maternal outcome in Keren Hospital, Eritrea |
title_fullStr | Quality and timeliness of emergency obstetric care and its association with maternal outcome in Keren Hospital, Eritrea |
title_full_unstemmed | Quality and timeliness of emergency obstetric care and its association with maternal outcome in Keren Hospital, Eritrea |
title_short | Quality and timeliness of emergency obstetric care and its association with maternal outcome in Keren Hospital, Eritrea |
title_sort | quality and timeliness of emergency obstetric care and its association with maternal outcome in keren hospital, eritrea |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9418268/ https://www.ncbi.nlm.nih.gov/pubmed/36028743 http://dx.doi.org/10.1038/s41598-022-18685-9 |
work_keys_str_mv | AT zewdehenoskiflom qualityandtimelinessofemergencyobstetriccareanditsassociationwithmaternaloutcomeinkerenhospitaleritrea |