Retrospective Study of Quality Care During Labour in Maternity Wards in Khomas Region, Namibia

Abstract

Quality of midwifery care can be defined as care delivered by midwives which is safe, effective, efficient, accessible, acceptable, patientcentred, equitable, and results in a positive pregnancy outcome. In 2013, the Government of the Republic of Namibia through the Ministry of Health and Social Services implemented the Presidential Commission of Inquiry into Maternal and Neonatal Mortality. The Commission reports that there are several factors impeding maternal and newborn health in the country. Furthermore, the commission noted that poor quality of midwifery care during labour was one of those factors. This research assessed the quality of midwifery care by reviewing maternity records and analysing the standard of midwifery care rendered during the first stage of labour of the women who gave birth at maternity ward at intermediate and referral hospitals. The present study is retrospective with a descriptive quantitative design conducted on 653 maternity records at these hospitals. Early opening of partographs is recommended as it could lead to early identification of problems and intervention plans. This study’s findings show that 402 (61.6%) partographs were mostly opened with women in the active phase of labour. A few partographs, 33 (5.1%), were opened in the latent phase of labour. However, of the partographs that were opened, the study’s results revealed that not all were managed according to the WHO guidelines. Poor documentation of midwifery interventions and care was noted, suggesting poor midwifery care. Of most deliveries, 499 (76.4%) were normal vaginal deliveries, followed by 151 (23.1%) who had caesarean section deliveries. The rest had assisted deliveries with one breech delivery. Based on the findings of this study, it can be concluded that midwifery care rendered during labour at the studied hospitals was substandard.