Essential obstetric care

Assessment and determinants of quality

Olusoji Adeyi, Richard Morrow

Research output: Contribution to journalArticle

Abstract

This paper reports on a study to develop and to apply methods for measuring the quality of essential obstetric care (EOC) in health centers. Based on a Nigerian guideline and an international guideline, and in consultation with local experts in primary care obstetrics, norms were established for equipment, personnel, supplies and the process of EOC, focusing on critical tasks. A combination of assessment methods was used, including observation of tasks performed during intrapartum care; use of data from records of care kept by midwives during the period of observation; use of data from records kept by midwives in the calendar year preceding the period of observation; exit interviews with clients; and inventories of equipment and supplies. Twelve health centers in three Local Government Areas (LGAs) and 360 clients in labor were included in the study. Quality of care was measured quantitatively as a score, calculated for each task and for each delivery in the health center. The results show that the methods developed are useful for: identifying quality score differences among health centers, and the effects of methods of assessment on quality scores; identifying aspects of EOC requiring improvements within each health center; and identifying factors influencing the quality of care, as a basis for effective quality improvement efforts. Regression models show that the most consistent and important predictor of quality scores is the use of printed forms (i.e. routine records of labor) during intrapartum care. Printed forms served as job aids, providing prompts that reminded midwives to perform specific tasks.

Original languageEnglish (US)
Pages (from-to)1631-1639
Number of pages9
JournalSocial Science and Medicine
Volume45
Issue number11
DOIs
StatePublished - Dec 1997

Fingerprint

obstetrics
Obstetrics
Midwifery
determinants
Quality of Health Care
Health
Observation
Equipment and Supplies
midwife
Guidelines
Local Government
labor
health
Quality Improvement
assessment method
Primary Health Care
Referral and Consultation
local government
Interviews
Delivery of Health Care

Keywords

  • Essential obstetric care
  • Maternal mortality
  • Methods
  • Nigeria
  • Quality

ASJC Scopus subject areas

  • Economics and Econometrics
  • Public Health, Environmental and Occupational Health
  • Social Psychology
  • Development
  • Health(social science)

Cite this

Essential obstetric care : Assessment and determinants of quality. / Adeyi, Olusoji; Morrow, Richard.

In: Social Science and Medicine, Vol. 45, No. 11, 12.1997, p. 1631-1639.

Research output: Contribution to journalArticle

Adeyi, Olusoji ; Morrow, Richard. / Essential obstetric care : Assessment and determinants of quality. In: Social Science and Medicine. 1997 ; Vol. 45, No. 11. pp. 1631-1639.
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