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Quality of maternal health care at Shoklo Malaria Research Unit in Mae La refugee camp in 2008 : an evaluation using WHO Safe Motherhood Needs Assessment


Document type: mthesis
Download file(s): 186298 (1008 KB)
Abstract: PROBLEM STATEMENT: As part of a quality improvement project a WHO Safe Motherhood Needs Assessment (SMNA) was performed at the SMRU clinic in Mae La refugee camp. OBJECTIVES: To describe availability, use and quality of perinatal care and to identify gaps in the provision of care. METHODS: Facility observations, record reviews, staff interviews and observations of deliveries were conducted using SMNA instruments with locally adapted structured survey forms. FINDINGS: Availability of appropriate drugs, supplies, equipment, facilities and transport was found to be adequate. Missing items were syphilis tests and health education materials. Essential elements of antenatal care, e.g., providing supplements and recording risk factors, all scored over 90%. The skills and abilities of the staff exceeded minimum standards, except for bladder care (19.3% catheterisation during labour), perineum care (episiotomy rate of 48.6%) and checking if placenta was complete (only 46.0%). Management of obstructed labour was done when reaching the action line of the partogram, although augmentation was done with delay in 30% of cases. DISCUSSION: While SMRU staff appeared accurate on following protocols and recording in patient files, direct observations put this in perspective. Knowledge of complicated deliveries and obstetric emergencies was adequate, but team performance in the delivery room was chaotic at times and variable delays between observation, decision and action were observed. CONCLUSION: Overall performance was adequate for the majority of SMNA items despite high staff turnover and junior staffing levels. Certain aspects of perinatal care require improvement preferably by a supervising doctor with obstetric skills.
Authors: Hoogenboom, G.
Country: Thailand
Category: Research
Department: Development Policy & Practice
Institute: KIT (Royal Tropical Institute)
Keywords: reproductive health , maternal and child health , health services
Language: eng
Organization: KIT - Royal Tropical Institute
PAGE: vii, 42
Year: 2010
Region: Southeast Asia
Right: © 2010 Hoogenboom
Subject: Health and Nutrition
Title: Quality of maternal health care at Shoklo Malaria Research Unit in Mae La refugee camp in 2008 : an evaluation using WHO Safe Motherhood Needs Assessment
Training: Master in International Health (MIH)