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Table 1 Routine delivery, EmOC and EmNC quality indicators [6]

From: Clinical and perceived quality of care for maternal, neonatal and antenatal care in Kenya and Namibia: the service provision assessment

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  
  1. *NA = not available in any surveys