Quality of maternal healthcare services in public health facilities of Addis Ababa: Documentation, prenatal and postnatal care, and key determinants of service delivery

Sintayehu A. Temesgen, Thinavhuyo R. Netangaheni

Abstract

This study assesses the quality of maternal healthcare services in Addis Ababa, Ethiopia, focusing on documentation practices, prenatal and postnatal care, and factors influencing high-quality services. A review of 354 maternity medical records from five public hospitals and ten public health centers evaluated the completeness and consistency of maternal healthcare documentation, including patient identification, prenatal care, and postnatal care services. The findings revealed gaps in prenatal care documentation, particularly in maternal medical history, risk factors, and continuity of care. While strengths were noted in patient identification and prenatal screening, challenges remain in adhering to clinical-guidelines and ensuring continuity, especially in postnatal services. Factors such as women's education, use of electronic medical records, obstetric assessments, and adherence to clinical-guidelines significantly influenced the quality of care. The study highlights the need for improved documentation practices, enhanced provider training, and better-adherence to clinical-standards to improve maternal healthcare outcomes in Addis Ababa.

Full Text:

PDF

References

WHO. Standards for improving quality of maternal and

newborn care in health facilities, WHO Library

Cataloguing-in-Publication Data WA 310, 2016, p.

Available

at:

http://www.who.int/about/licensing/copyright_form.

Hu W, Hu H, Zhao W, Huang A, Yang Q and Di J. Current

status of antenatal care of pregnant women—8

provinces in China, 2018. BMC Public Health 2021;

(1),

pp.

–11.

Available

at:

https://doi.org/10.1186/s12889-021-11154-4.

Twum P, Qi J, Aurelie KK and Xu L. Effectiveness of a free

maternal healthcare programme under the National

Health Insurance Scheme on skilled care : evidence

from a cross- sectional study in two districts in Ghana.

BMJ Open 2018; 8(11): e022614. pp. 1–8. Available

at: https://doi.org/10.1136/bmjopen-2018-022614.

FDRE. Health sector transformation in quality. Health sector

transformation in quality 2016; p. 205.

Duga AL and Teshite DT. Maternal and perinatal health in

Ethiopia. Archives of Anesthesiology and Critical

Care 2018; 4(4), pp. 527–534.

Ahmed AY and Husein AM. Utilization of Primary Health

Care and Its Associated Factors among Women of

Childbearing Age Living in Mogadishu-Somalia.

Health 2020; 12(12), pp. 1640–1652. Available at:

https://doi.org/10.4236/health.2020.1212120.

Tadesse T, Regassa N, Kifle D, Jara D and Abegaz KH.

Framework for maternal morbidity and mortality

interventions in Ethiopia : a systematic review

protocol. BMJ Open Access 2023; 13(:e075879), pp.

–11. Available at: https://doi.org/10.1136/bmjopen

-075879.

FMoH. Health Sector Transformation Plan II, 2020/21

/25. 2021c; pp. 13–116.

Ayele AA, Getaye TY and East L. Ethiopia’s commitment

towards achieving sustainable development goal on

reduction of maternal mortality: There is a long way

to go. Women’s Health 2021; 17: 1–4. Available at:

https://doi.org/10.1177/17455065211067073.

Gebre E, Worku A and Bukola F. Inequities in maternal

health services utilization in Ethiopia 2000-2016:

Magnitude, trends, and determinants’, Reproductive

Health

;

(1):

–9.

Available

at:

https://doi.org/10.1186/s12978-018-0556-x.

FMoH's. Health and Health Related Indicators. 2021

FMoH. National In-Service Training Implementation Guide

for the Health Sector. 2021a; (January), pp. 1–49.

Available

at:

https://pdf.usaid.gov/pdf_docs/PA00TWSP.pdf.

Ketemaw A, Tareke M, Dellie E, Sitotaw G, Deressa Y,

Tadesse G, Debalkie D , Ewunetu M, Alemu Y and

Debebe D. Factors associated with institutional

delivery in Ethiopia: A cross sectional study. BMC

Health Services Research 2020; 20(1), pp. 1–6.

Available at: https://doi.org/10.1186/s12913-020

-7.

Central Statistical Agency (CSA) [Ethiopia], ICF. Ethiopia

Demographic and Health Survey 2016. Addis Ababa,

Ethiopia, and Rockville, Maryland, USA: CSA and

ICF;

Available

from:

https://dhsprogram.com/pubs/pdf/FR328/FR328.pdf

DHS Program

Ethiopian Public Health Institute (EPHI), Ethiopian Ministry

of Health. Ethiopia Service Provision Assessment

Plus Survey 2014. Addis Ababa, Ethiopia: EPHI and

Ministry of Health; 2014. Available from:

https://www.researchgate.net/profile/Terefe

Gelibo/publication/318012454_Ethiopia_Service_

Provision_Assessment_Plus

Census_2014/links/5a9db261aca272cd09c21f28/Ethi

opia-Service-Provision-Assessment-Plus-Census

pdfWASH in Health Care Facilities+2ResearchGate+2ResearchGate+2

World Health Organization (WHO). Service Availability and

Readiness Assessment (SARA): An annual

monitoring system for service delivery. Geneva,

Switzerland: WHO; 2015. Available from:

https://www.who.int/healthinfo/systems/sara/en/

Tessema ZT, Lake YL, Antehunegn GT and Birhanu

AT. Determinants of postnatal care utilization in sub

Saharan Africa: a meta and multilevel analysis of data

from 36 sub-Saharan countries’, Italian Journal of

Pediatrics 2020; 46(175): 1–12. Available at: https://doi.org/10.1186/s13052-020-00944-y.

J KS, Kituaa YW and Kituac DW. Availability and Quality

of Family Planning Services in the Democratic

Republic of the Congo : High Potential for

Improvement. Global Health: Science and Practice

; 5(2): 274–285.

Hagaman AS, Singh K, Abate M, Alemu H, Kefale AB,

Bitewulign B, Estifanos AS, Kiflie A, Mulissa

Z, Tiyo H, Seman Y, Meseret ZT and Magge H. The

impacts of quality improvement on maternal and

newborn health : preliminary findings from a health

system integrated intervention in four Ethiopian

regions. BMC Health Services Research 2020; 20(3):

–12.

Berehe TT and Modibia LM. Assessment of Quality of

Antenatal Care Services and Its Determinant Factors

in Public Health Facilities of Hossana Town, Hadiya

Zone , Southern Ethiopia: A Longitudinal Study.

Advances in Public Health 2020; pp. 1–11.

Kare AP and Gujo AB. Quality of antenatal care and

associated factors among pregnant women attending

government hospitals in Sidama Region , Southern

Ethiopia. SAGE Open Medicine, 2021; 9: 1–8.

Available

at:

https://doi.org/10.1177/20503121211058055.

Negash WD, Fetene SM, Shewarega ES, Fentie EA,

Asmamaw DB, Teklu RE, Aragaw FM, Belay DG,

Alemu TG and Eshetu HB. Multilevel analysis of

quality of antenatal care and associated factors among

pregnant women in Ethiopia : a sectional study

community based cross. BMJ Open 2022;

(7):e063426),

pp.

–10.

Available

at:

https://doi.org/10.1136/bmjopen-2022-063426.

Raru TB, Ayana GM, Bahiru N, Deressa A, Alemu A and

Birhanu A. Quality of antenatal care and associated

factors among pregnant women in East Africa using

Demographic and Health Surveys : A multilevel

analysis. Women’s Health 2022; 18: 1–9. Available at:

https://doi.org/10.1177/17455065221076731.

Hussen MA and Worku BT. Quality of Antenatal Care

Service and Factors Associated with Client

Satisfaction at Public Health Facilities of Bele Gasgar

District. Journal of Patient Experience 2022; 9: 1–9.

Available at:

https://doi.org/10.1177/23743735221083163.

FMoH Ethiopia. National Guideline for Family Planning

Services In Ethiopia Third Edition. 2020 (July); pp. 1

Nuolabong C, Akuffo KO, Kabiri M, Nortey P, Maya ET,

Junior IOD and Danso-Appiah A. Utilization of

Facility-based Delivery Services in the in theWa

Municipality, Ghana. Research Square. Europe PMC

Plus 2022; DOI: 10.21203/rs.3.rs-1250026/v1.

Kibesa SJ, Kitua YW and Kitua DW. Determinants of

Antenatal Healthcare Services Utilisation: A Case of

Dodoma, Tanzania', East African Health Research

Commision: research for Health and Prosperity 2022;

(9): 155–161.

Banke-Thomas OE, Banke-Thomas AO and Ameh CA.

Factors influencing utilisation of maternal health

services by adolescent mothers in Low-and middle

income countries: A systematic review. BMC

Pregnancy and Childbirth2017; 17(1): 1–14.

Available at: https://doi.org/10.1186/s12884-017

-3.

Nuryana D, Viwattanakulvanid P and Romadlona NA.

Maternal health services utilization and its

contributing factors among adolescent mothers’, f

Journal of Public Health Science (IJPHS) 2022;

(1):

–87.

Available

at:

https://doi.org/10.11591/ijphs.v11i1.21041.

Brizuela V, Leslie HH, Sharma J, Langer A and Tunçalp O.

Measuring quality of care for all women and

newborns: how do we know if we are doing it right?

A review of facility assessment tools. The Lancet

Global Health 2019; 7(5): e624–e632. Available at:

https://doi.org/10.1016/S2214-109X(19)30033-6.

Meghea CI, Corser W and You Z. Electronic Medical Record

Use and Maternal and Child Care and Health

Electronic Medical Record Use and Maternal and

Child Care and Health’, Maternal and Child Health

Journal [Preprint] 2020; (November). Available at:

https://doi.org/10.1007/s10995-015-1912-x.

Bans-Akutey A and Tiimub BM. Triangulation in Research’,

Triangulation in Research: Academia Letters Article

(September); 33: 1–7. Available at:

https://doi.org/10.20935/al3392.

Refbacks

  • There are currently no refbacks.