Table 1 Routine delivery, EmOC and EmNC quality indicators [6]
Indicator | Indicator in SPA | Kenya (%) | Namibia (%) | Comments |
|---|---|---|---|---|
Routine Delivery Care | ||||
Monitor Labor with Partograph | Partograph (observed) | 75.93 | 50.00 | |
Infection prevention | Observed hand disinfectant | 35.24 | 55.08 | |
Measure Blood Pressure | Take BP, routine | 71.10 | 43.36 | |
Controlled cord traction | Apply cord traction, routine | 89.08 | 63.28 | |
Injection of Oxytocin within 1 minute of delivery | Injectable oxytocin/syntocin, observed, valid date | 79.40 | 45.31 | |
Uterine massage | Massage fundus through abdomen, routine | 88.09 | 83.98 | |
Place baby on abdomen | Delivery of baby to abdomen | 49.13 | Only Kenya | |
Dry baby immediately | Dry and wrap newborns to keep warm | 98.26 | Only Kenya | |
Apply eye ointment | Apply tetracycline eye ointment to both eyes | 81.14 | 65.23 | Only in Kenya, in other countries used “Antibiotic eye drops/ointment (not chloramphenicol)” |
Weigh baby after delivery | Two indicators: “Weigh baby, routine” & “newborn scale observed” | 98.76 | 89.84 | Used “newborn scale observed” as indictor |
Initiate Breastfeeding within 1 hour | Breastfeeding 1st hour | 95.29 | Only in Kenya | |
Delay bathing at least 6 hours after delivery | Give full bath within minutes/few hours after | 90.57 | 41.41 | Only in Kenya, in Namibia “gave bath within 24 hours”, removed from analysis because confusing |
Emergency Obstetric Care (EmOC) | ||||
Basic functions | ||||
Parenteral Antibiotics | Ever or past 3 months: used parenteral antibiotics | 68.73 | 16.80 | |
Parenteral Oxytocin | Injectable oxytocin/syntocin, observed | 79.40 | 45.31 | |
Parenteral anti-convulsing | Injectable diazepam observed, /Injectable magnesium sulfate observed | 74.69 / 52.36 | 68.75 / 14.84 | |
Manual removal of placenta | Used manual placental removal, past 3 months | 48.64 | 11.33 | |
Manual removal of retained products of conception | Past 3 months: retained products extracted | 70.43 | 37.50 | |
Instrument delivery | C-sect: sterile instruments in tray/drum package | 93.33 | 86.11 | |
Comprehensive | ||||
Blood transfusion | Provide blood transfusion | 25.06 | 10.55 | Also looked at ability to transfer for blood transfusion |
C-section | Use indictors for “instrument delivery” above | |||
Emergency Newborn (EmNC) | ||||
Basic Functions | ||||
Injectable antibiotic for newborn sepsis | Injectable amoxicillin/ampicillin observed, Injectable gentamicin observed | 9.18 / 55.09 | 16.80 / 28.52 | |
Newborn resuscitation with mask and bag | Infant resuscitation bag/mask or tube/mask) observed | 81.64 | 62.11 | |
Kangaroo mother care | Kangaroo mother care, routine | 50.37 | Only in Kenya | |
Express milk with spoon | NA | |||
Dexamethasone | NA | |||
Comprehensive | ||||
IV fluids for newborn | IV fluid Observed /IV infusion set observed | 88.56 / 91.32 | 86.33/ 96.88 | |
Antenatal Care (ANC) | ||||
Guidelines on ANC | NA | |||
Staff trained in ANC | Protocols: teaching aids for ANC, observed | 58.72 | 36.50 | |
Blood pressure apparatus | Take Blood pressure, routine, observed | 68.75 | 38.20 | |
Hemoglobin | Blood test for anemia, routine, observed | 39.51 | 30.41 | |
Urine dipstick- protein | Urine test for protein, routine, observed | 36.47 | 33.09 | |
Iron tablets | Iron tablet available, observed | 45.18 | Only in Kenya | |
Folic Acid Tablets | NA | |||
Tetanus toxoid Vaccines | Available today | 95.86 | 94.24 | |
Other quality indicators | ||||
Number of days a week ANC offered | ANC offered 5+ days a week | 84.58 | 42.09 | |
Treat STIs | Routinely treat STI | 59.17 | 68.13 | |