Local health workers’ perceptions of substandard care in the management of obstetric hemorrhage in rural Malawi

BMC Pregnancy and Childbirth

Research Article

Luc van Lonkhuijzen¹  Jos van Roosmalen²  Anneke Korevaar³  Dieudonné Bwirire⁴  Richard Chidakwani⁵  Jogchum Jan Beltman⁶  Thomas van den Akker⁷ 

[1] Department of Gynecologic Oncology, University of Toronto, Toronto, Canada;Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands;Department of Medical Humanities, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands;Department of Obstetrics, University Medical Centre Groningen, Groningen, The Netherlands;Médicins Sans Frontières, Thyolo, Malawi;Thyolo District Health Office, Ministry of Health, Thyolo, Malawi;Thyolo District Health Office, Ministry of Health, Thyolo, Malawi;Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands;Thyolo District Health Office, Ministry of Health, Thyolo, Malawi;Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands;Médicins Sans Frontières, Thyolo, Malawi;

关键词: Health Worker;    Maternal Death;    District Hospital;    Medical Assistant;    Obstetric Care;   

DOI  :  10.1186/1471-2393-13-39

 received in 2012-11-06, accepted in 2013-02-07,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundTo identify factors contributing to the high incidence of facility-based obstetric hemorrhage in Thyolo District, Malawi, according to local health workers.MethodsThree focus group discussions among 29 health workers, including nurse-midwives and non-physician clinicians (‘medical assistants’ and ‘clinical officers’).ResultsFactors contributing to facility-based obstetric hemorrhage mentioned by participants were categorized into four major areas: (1) limited availability of basic supplies, (2) lack of human resources, (3) inadequate clinical skills of available health workers and (4) substandard referrals by traditional birth attendants and lack of timely self-referrals of patients.ConclusionHealth workers in this district mentioned important community, system and provider related factors that need to be addressed in order to reduce the impact of obstetric hemorrhage.

【 授权许可】

CC BY   
© Beltman et al.; licensee BioMed Central Ltd. 2013