Health care workers’ experiences of managing foetal distress and birth asphyxia at health facilities in Northern Uganda

Reproductive Health

Elizabeth Ayebare¹  Grace Ndeezi²  Jolly Nankunda³  Claudia Hanson⁴  Anna Hjelmstedt⁵  Wibke Jonas⁵  James K. Tumwine⁶ 

[1]Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda

[2]Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda

[3]Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda

[4]Mulago Specialized Women’s and Neonatal Hospital, Kampala, Uganda

[5]Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden

[6]Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK

[7]Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden

[8]Mulago Specialized Women’s and Neonatal Hospital, Kampala, Uganda

关键词: Birth asphyxia;    Foetal distress;    Healthcare workers;    Low income setting;    Midwives;    Referral systems;   

DOI  :  10.1186/s12978-021-01083-1

来源: Springer

【 摘 要 】

BackgroundBirth asphyxia is one of the leading causes of intrapartum stillbirth and neonatal mortality worldwide. We sought to explore the experiences of health care workers in managing foetal distress and birth asphyxia to gain an understanding of the challenges in a low-income setting.MethodsWe conducted in-depth interviews with 12 midwives and 4 doctors working in maternity units from different health facilities in Northern Uganda in 2018. We used a semi-structured interview guide which included questions related to; health care workers’ experiences of maternity care, care for foetal distress and birth asphyxia, views on possible preventive actions and perspectives of the community. Audio recorded interviews were transcribed verbatim and analysed using inductive content analysis.ResultsFour categories emerged: (i) Understanding of and actions for foetal distress and birth asphyxia including knowledge, misconception and interventions; (ii) Challenges of managing foetal distress and birth asphyxia such as complexities of the referral system, refusal of referral, lack of equipment, and human resource problems, (iii) Expectations and blame from the community, and finally (iv) Health care worker’ insights into prevention of foetal distress and birth asphyxia.ConclusionHealth care workers described management of foetal distress and birth asphyxia as complex and challenging. Thus, guidelines to manage foetal distress and birth asphyxia that are specifically tailored to the different levels of health facilities to ensure high quality of care and reduction of need for referral are called for. Innovative ways to operationalise transportation for referral and community dialogues could lead to improved birth experiences and outcomes.

【 授权许可】

CC BY