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Quality of intrapartum care for healthy women with spontaneous onset of labour in Rwanda: A health facility-based, cross-sectional study.

Journal article
Authors Judith U Mukamurigo
Anna Dencker
Laetitia Nyirazinyoye
Joseph Ntaganira
Marie Berg
Published in Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives
Volume 19
Pages 78-83
ISSN 1877-5764
Publication year 2019
Published at Institute of Health and Care Sciences
Pages 78-83
Language en
Links dx.doi.org/10.1016/j.srhc.2019.01.0...
www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords Bologna score, Childbirth, Intrapartum care, Quality of care management, Women
Subject categories Health Sciences, Other Medical Sciences

Abstract

To investigate the quality of intrapartum care provided at Rwandan healthcare facilities to women undergoing normal pregnancy and spontaneous full-term labour.A cross-sectional study was conducted over eight weeks during 2014-2015 in 18 healthcare facilities in Kigali City and the Northern Province: eight health centres, seven district hospitals, one provincial hospital, one private hospital, and one referral hospital. Data were collected from medical records and a questionnaire including the Bologna score with its five variables: presence of a companion, use of partograph, no augmentation of labour, birth in a non-supine position, and skin-to skin contact.Among the 435 women who fulfilled the inclusion criteria during the study period, mean age was 27.4 years and 41.8% were primiparous. The assisting healthcare professionals were midwives (49.4%), nurses (28.8%), and physicians (22%), and birth occurred at health centres (29%), district hospitals (40%), and the referral hospital (31%). Mean Bologna score was 2.03 of the maximum 5 (range: 0-4). Only one woman (0.2%) had a companion present (her husband). A partograph was used for the majority (84.8%), and 88.0% had no augmentation of labour with oxytocin. Few (6.2%) gave birth in a non-supine position, and few (12.4%) had early skin-to-skin contact with their newborn.There are several areas for improving childbirth care according to the Bologna score. Healthy newborns should be placed skin-to-skin with their mothers shortly after birth, non-supine birthing positions should be encouraged, and the importance of a companion during labour and birth should be considered.

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