Quality of Intrapartum Care: Direct Observations in Selected Health Facilities in Zambia

Approximately 303,000 women die annually while giving birth, worldwide,\r\nand more than 99% of the deaths occur in developing countries. In Zambia, a\r\ndeveloping country situated in sub-Saharan Africa, most of the maternal\r\nmortalities occur during the intrapartum and immediate postpartum periods,\r\narising from postpartum hemorrhage, sepsis, obstructed labor, and hypertensive\r\ndisorders. Aim: The aim of this study was to assess the quality of\r\nintrapartum services provided in health facilities in the country. Methodology: Guided by a descriptive cross sectional design, data were collected from 264 women in labor using a World Health\r\nOrganization validated observation checklist. Convenience sampling was used to\r\nrecruit the women, while multistage sampling was used to select four health\r\nfacilities. The Social Package for Social Sciences, version 23 was used to\r\nanalyze the data. Results: One health facility met the World Health\r\nOrganization 80% minimum standard in four out of the five categories used to\r\nmeasure quality in intrapartum care, while the other three met the minimum\r\nstandard in one category each. Conclusion: Low numbers of midwives,\r\ninadequate supplies and equipment were\r\nmajor obstacles to following national and international agreed standards for\r\nproviding optimal care during intrapartum period. Recommendations: There is need for local and national stakeholders in Zambia to urgently address the\r\nstructural barriers that were observed, as well as invest in sufficient numbers\r\nof adequately trained and motivated midwives.