Obstetrical routines and interventions in a delivery unit in Jimma, Ethiopia. The WANT study.

Abstract

Motivation: Collaboration between Oslo University and Jimma University include plans for interventional studies to improve maternal and perinatal health in the Jimma area according to WHO recommendations on health care during labour and childbirth. No written documentation existed on the obstetrical routines in the maternity ward at Jimma University Specialized Hospital (JUSH). In order to be able to conduct interventional studies, baseline data on the obstetrical routines was needed. Problem statement: The main aim of the WANT study was to observe how the maternity ward at JUSH was organized, and to gather data regarding clinical routines and practices just before, during and after childbirth. In this thesis we have assessed the clinical routines and procedures performed in the maternity ward at JUSH, and compared them to the WHO Guidelines for maternal and newborn care. Approach: We were 5 medical students who spent three weeks in the maternity ward at Jimma University Hospital to conduct an observational study. The data was collected on case report forms that consisted of four modules shadowing different aspects of delivery and newborn care. The modules were transferred into Excel documents, where the data was analysed. Results: 87 women were included in the WANT study. We have background information on the women and information regarding the admission examination. Observations on 56 deliveries were recorded, and 59 children were born. We have solid information on the 56 deliveries regarding procedures, examination and newborn care. Although some of the modules were not completed for every woman and child, we believe that the data material fairly reflects the clinical routines in the maternity ward at JUSH. Conclusion: We found that the admission procedures for women in labour are in accordance with the WHO guidelines for integrated management of Pregnancy and Childbirth. The maternity ward at JUSH also has good routines regarding prevention of postpartum haemorrhage. Jimma University Specialized Hospital has several challenges that can be dealt with at low cost.