Technical quality of institutional delivery service in Jimma Zone, Southwest Ethiopia

Abstract

Background: Quality services improve health outcomes by providing clients with respectful and technically sound services, delivered according to standard that was known to maximize their health impact. The key strategy to reduce maternal mortality ratio and improving maternal health is increasing quality of maternal health care including institutional birth service. In Ethiopia the proportions of births attended by skilled personnel is very much lower than sub-Saharan Africa. Only 16% of deliveries were attended in health facility at national level and13% birth attended in Oromia region. One of the reasons for low utilization of institutional delivery was inadequate quality service. One of quality dimension is technical quality. But there was no evidence about the technical quality of Institutional delivery service in Jimma zone. Objective: The aim of thesis study is to assess the technical quality of institutional birth service among public health centers and primary hospitals available in Jimma Zone and Town administration. Methods: A facility based descriptive cross sectional study design was employed from February 29 – March 20 /2016 among selected 4 public primary hospitals and 13 health centers in Jimma Zone.A random sampling method was used for selecting 13(30%) of the health centers and All primary hospitals of Jimma Zone that were included in the study. A total of one hundred seventy two deliveries (53 from hospitals and 119 from health centers)with 92 observations during daytime and 80 observations during nighttime were observed in labor wards. Data were cleaned and entered into EPI-data version 3.1, then exported in to SPSS version 20 for descriptive analysis. Result was presented in descriptive statistics using tables and graphs. Result: All primary hospitals and thirteen health centers gave response for the study making response rate 100%.The input survey result showed that the study facilities fulfilled 54% of physical setting,74.5% of essential supply and equipment, 62% delivery room, 81.2%professional’savailability in 17 health facilities. The total input shows 76%.The process survey result showed the technical practice was available in 11(67%)facilities and provider to client interaction was practiced in 108(63%)observation in 10 facilities. Both scored below the standard. Conclusion: In majority of public health facilities, the technical practice and interpersonal skill on provider to client interaction practice were not carried out based on the standard guideline. This shows relatively there is adequate input to carry out technical quality service. But the functional process practice was not proportional to input. The overall facility structure, technical practice and providers to client interaction score were below the standard in majority of the health facilities. Therefore the technical quality care result in terms of input and process shows there is low quality. This shows facilities and respective organization have an assignment to fill the gap & to ensure technical quality in maternal health unit.