TITLE:
Assessment of quality of postnatal care services offered to mothers in Dedza district, Malawi
AUTHORS:
Lydia Kanise Chimtembo, Alfred Maluwa, Angela Chimwaza, Ellen Chirwa, Mercy Pindani
KEYWORDS:
Quality Postnatal Care; Reproductive Health Standards; Postnatal Care Structure, Process and Outcome; Maternal and Neonatal Health; Postnatal Care Standards
JOURNAL NAME:
Open Journal of Nursing,
Vol.3 No.4,
July
26,
2013
ABSTRACT: This
study was conducted to assess quality of postnatal care that midwives provide
to women seeking postnatal services in health facilities in Dedza district, the
central region ofMalawi.
The study design was descriptive cross sectional and utilized quantitative data
collection and analysis method to determine structural, process and outcome
components of postnatal care in two facilities that offer emergency obstetric
and neonatal care and five that offer basic emergency obstetric and neonatal
care. All 60 midwives who were providing postnatal care during the time of
study in the district were interviewed using a structured questionnaire. In
addition, the midwives actual practice was observed and compared to a standard
checklist on postnatal care practice which was developed by the Malawi Ministry
of Health. Data were analyzed using SPSS version 16.0. Results show that
structure for providing postnatal counseling services was inappropriate and
inadequate. Furthermore, the contents of postnatal services were below
reproductive health standards because the clients were neither monitored nor
examined physically on discharge. On average, all the seven facilities scored
48% on postnatal services rendered which is far below the recommended 80%
according to the Reproductive Health Standards. There is a need to provide
basic infrastructure in all the basic emergency obstetric and neonatal care
facilities. In addition, refresher training courses for midwives in maternal
and neonatal health with emphasis on postnatal care are recommended. There
is also a need to restructure the maternal and neonatal health departments in
the facilities so that the postnatal care units become stand-alone priority sites
to improve the quality of the postnatal care services rendered.