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Quality of anaesthesia for Caesarean sections: a cross‐sectional study of a university hospital in a low‐income country
Author(s) -
Eriksson Jesper,
Baker Tim,
Jörnvall Henrik,
Irestedt Lars,
Mulungu Moses,
Larsson Emma
Publication year - 2015
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12553
Subject(s) - medicine , caesarean section , tanzania , apgar score , dar es salaam , anesthesia , labour ward , obstetrics , caesarean delivery , pregnancy , emergency medicine , birth weight , genetics , environmental science , environmental planning , biology
Objective To evaluate the quality of anaesthesia for Caesarean sections at Muhimbili National Hospital, Dar es Salaam, Tanzania. Method We developed an instrument consisting of 40 quality indicators using an expert group process based on the existing literature. Using the instrument, we observed 50 Caesarean sections. Twenty‐eight of the indicators were structural indicators, such as essential drugs, oxygen supply and anaesthetic equipment. Twelve were process indicators such as evaluation of airway, blood pressure assessment or insertion of an intravenous line. Results The median patient age was 28.5 years. A total of 75% (range 61–82%) of the structural indicators were present in the operating theatres, and 55% (range 33–83%) of the process indicators were performed. The neonates’ median Apgar score was 9 (range 3–10). Seven babies required ventilation, four babies were stillborn, and all others were alive at follow‐up 2 days after partus. All mothers were alive 2 days post‐surgery. Conclusion The low process score suggests that quality improvement initiatives should focus on the processes of anaesthesia for Caesarean sections rather than new drugs and equipment.