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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Effect of audit and feedback on the availability, utilisation and quality of emergency obstetric care in three districts in Malawi
Women and Birth, Volume 21, No. 4, Year 2008
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Description
Background: Facility-based maternal death reviews and criterion-based clinical audit, were introduced in three districts in Malawi in 2006. Research question: Can audit and feedback improve the availability, utilisation and quality of emergency obstetric care (EmOC)? Participants and methods: Observational study in which emergency obstetric care offered to women who gave birth in 73 health facilities (13 hospitals and 60 health centres) in three districts in Malawi in 2005 (baseline, 41,637 women) was compared to 2006 (43,729 women) and 2007 (51,085 women). Results: The number of comprehensive and basic EmOC facilities did not change over the 3-year period (p for trend = 1.000). Although institutional delivery rate decreased in 2006, overall it increased over 3 years (p for trend < 0.001) - 31.8% (2005), 31.1% (2006) and 34.7% (2007), and Caesarean section rate was low and did not change (p for trend = 0.257) - 1.7% (2005), 1.6% (2006) and 1.5% (2007). There was a significant increase in the met need for EmOC (p for trend < 0.001) - 15.2% for 2005, 17.0% for 2006 and 18.8% for 2007. Maternal mortality decreased significantly from 250 per 100,000 women in 2005 to 222 in 2006 and 182 in 2007 (p for trend < 0.001). Similarly, the case fatality rate decreased monotonically (p for trend < 0.001) - 3.7% (2005), 3.0% (2006) and 1.5% (2007). Discussion: Audit and feedback can improve availability, utilisation and quality of emergency obstetric care in countries with limited resources. Conclusion: There is need to increase availability of emergency obstetric care by upgrading some health centres to EmOC level through training of staff and provision of equipment and supplies. © 2008 Australian College of Midwives.
Authors & Co-Authors
Kongnyuy, Eugene Justine
United Kingdom, Liverpool
Liverpool School of Tropical Medicine
Leigh, Bailah
Malawi, Lilongwe
Ministry of Health Malawai
Van Den Broek, Nynke R.
United Kingdom, Liverpool
Liverpool School of Tropical Medicine
Statistics
Citations: 57
Authors: 3
Affiliations: 2
Identifiers
Doi:
10.1016/j.wombi.2008.08.002
ISSN:
18715192
Research Areas
Health System And Policy
Maternal And Child Health
Study Locations
Malawi
Participants Gender
Female