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Criteria‐based audit to improve women‐friendly care in maternity units in Malawi
Author(s) -
Kongnyuy Eugene J.,
Mlava Grace,
Van Den Broek Nynke
Publication year - 2009
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2008.00990.x
Subject(s) - medicine , childbirth , audit , toilet , maternity care , nursing , family medicine , health care , pregnancy , accounting , genetics , pathology , economics , business , biology , economic growth
Aim: To assess and improve women‐friendly care in maternity units in Malawi. Methods: We interviewed 280 women about the care they received during childbirth at 29 different health centers. Results were compared with standards for women‐friendly care, developed locally and based on evidence from World Health Organization manuals. The audit results were presented, and recommendations were made and implemented. A re‐audit (involving 367 women) was conducted 3 months later. Results: Significant improvements were recorded on greeting clients (74.6 vs 87.7%; P < 0.001), respect for clients (91.1 vs 98.6%; P < 0.001), support by a companion during labor (58.9 vs 75.6%; P < 0.001), informing clients about different birthing positions (68.6 vs 79.3%; P = 0.002), allowing clients to adopt different birthing positions (67.9 vs 83.4%; P < 0.001), cleanliness of maternity wards (89.6 vs 97.0%; P < 0.001), speaking to clients using simple language (92.1 vs 98.6%; P < 0.001), ensuring privacy with curtains or screens (86.1 vs 92.1%; P < 0.012), and client willing to recommend the health facility to a friend (94.6 vs 98.6%; P = 0.004). However, there were no significant changes in the level of self‐introduction by providers (62.5 vs 68.7%; P = 0.103) and provision of a clean bathroom and toilet (83.6 vs 80.4%; P = 0.282). Surprisingly, there was a significant deterioration in the use of linen to ensure privacy (86.4% vs 74.9%; P < 0.001). Overall, satisfaction of women increased by 9%. Conclusion: The criteria‐based audit was associated with an improvement in the quality of women‐friendly care services in maternity units in Malawi.