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Obstetric competence among referral healthcare providers in Mali
Author(s) -
Huchon Cyrille,
Arsenault Catherine,
Tourigny Caroline,
Coulibaly Aliou,
Traore Mamadou,
Dumont Alexandre,
Fournier Pierre
Publication year - 2014
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2014.01.014
Subject(s) - medicine , referral , competence (human resources) , family medicine , health care , nursing , cross sectional study , psychology , social psychology , pathology , economics , economic growth
Objective To determine the factors associated with obstetric competency and clinical practice among obstetric care providers in referral health centers in Mali. Methods The present cross‐sectional study was conducted between March and May 2012 among 140 obstetric care providers (obstetric nurses, midwives, and physicians) working in referral health centers in Mali. Emergency obstetric care knowledge and skills were evaluated with clinical vignettes developed using national Malian guidelines. The vignettes covered 5 areas of emergency obstetric care, and the results were used to generate a competency score. A backward stepwise random‐effects model using a maximum likelihood estimator was applied to evaluate variables independently associated with competency score. Results Out of 100, the mean ± SD score was 57.8 ± 11.2 for obstetric nurses, 66.4 ± 14.7 for midwifes, and 78.6 ± 13.4 for physicians ( P < 0.001). Three variables were significantly associated with a higher competency score: professional qualification, working in an urban setting, and working in a health center with a smaller number of obstetric care providers. Conclusion Increasing the in‐service training of both rural staff and lower‐level healthcare workers working in larger health centers via facility‐based maternal death reviews might help to improve clinical practice and maternal health outcomes.