Table 3 Mean percentages of QoC scores for different components of normal vaginal delivery and caesarean section delivery by type of study facility
Components of normal vaginal and caesarean delivery care services | % of QoC score by type of facility | |||
|---|---|---|---|---|
DH | MCWC | |||
Number of activities observeda | Mean % of activities performed | Number of activities observeda | Mean % of activities performed | |
Normal vaginal delivery | ||||
Rapid initial assessment | 9 | 45.6 | 9 | 46.7 |
Explanation of services to be provided | 7 | 67.9 | 7 | 73.6 |
Review and filling-up the clinical history | 16–24 | 55.3 | 13–24 | 57.9 |
Physical examinations between contractions | 12–14 | 40.1 | 13–14 | 55.7 |
Obstetric examination between contractions | 5 | 58.0 | 5 | 72.0 |
Vaginal examination | 12–13 | 62.8 | 13 | 74.6 |
Use of partograph and adjustments to the birth plan | 13–14 | 9.7 | 13–14 | 11.0 |
Preparation for assisting birth | 11 | 42.7 | 11 | 74.5 |
Assist the woman to have a safe and clean birth | 16–22 | 80.8 | 16–22 | 85.8 |
Initial assessment of the newborn and providing immediate newborn care | 8–11 | 78.6 | 8–11 | 78.4 |
Active management of the third stage of labor | 16–17 | 63.0 | 16–17 | 71.5 |
Immediate postpartum care | 6–12 | 68.7 | 6–12 | 89.7 |
Disposal of used instruments and medical waste | 10 | 43.5 | 10 | 76.5 |
Monitoring of newborn in immediate postpartum period | 10–37 | 32.8 | 33–37 | 33.6 |
Close monitoring of the woman for at least two hours after the childbirth | 37–39 | 49.5 | 38–39 | 54.8 |
Neonatal resuscitation if needed | 1–13 | 86.7 | 4–13 | 100.0 |
Caesarean section (CS) delivery | ||||
Informing the clients regarding indication, risks and benefit of CS | 13–14 | 51.7 | 13–14 | 65.7 |
Ensure fitness for surgery through physical and laboratory examinations | 5 | 52.0 | 4–5 | 81.4 |
Preparation of operation theater and readiness of providers for surgery | 11 | 70.9 | 11 | 83.8 |
Preparation of the patients for surgery | 7 | 62.9 | 7 | 88.8 |
Provide anesthesia | 7–8 | 84.0 | 8 | 95.5 |
Opening of the abdominal layer | 8 | 84.2 | 8 | 100.0 |
Opening of the uterus | 7–9 | 90.0 | 8–9 | 92.0 |
Delivery of the baby | 7 | 80.0 | 7 | 89.8 |
Delivery of the placenta and exploration of the peritoneal cavity | 4–7 | 58.1 | 5–7 | 68.0 |
Closure of the uterus | 7–9 | 88.5 | 8–9 | 96.0 |
Closure of the abdominal wall | 6 | 98.9 | 6 | 100.0 |
Completion of all tasks of post procedure | 8 | 55.8 | 8 | 77.7 |
Postoperative monitoring and ensure postnatal care | 8–16 | 71.2 | 10–16 | 79.2 |
Monitoring of newborn in immediate postpartum period | 37 | 34.1 | 36–37 | 33.8 |
Resuscitation of newborn if needed | b | – | 2 | 50.0 |