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Women's satisfaction with existing labour and delivery services in Ethiopia: a systematic review and meta-analysis.

ABSTRACT: OBJECTIVE:To estimate the pooled prevalence of women's satisfaction with existing labour and delivery services in Ethiopia. DESIGN:Systematic review and meta-analysis. METHODS:MEDLINE/PubMed, Scopus, Hinari, Google Scholar and web of science electronic databases were searched for the study. This meta-analysis included nineteen cross-sectional studies. Cochrane I2 statistics were used to check the heterogeneity of the studies. Subgroup and sensitivity analysis were conducted with the evidence of heterogeneity. Egger test with funnel plot were used to investigate publication bias. RESULT:Nineteen studies were included in the systematic review and meta-analysis. The overall prevalence of women's satisfaction with existing labour and delivery services in Ethiopia was 70.54% (95% CI 60.94 to 80.15). Having informal education of the women (adjusted OR (AOR)=2.19; 95%?CI 1.47 to 3.25), time to be seen by the healthcare providers within 20?min (AOR=2.97; 95%?CI 2.11 to 4.19), receiving free service (AOR=5.01; 95%?CI 2.87 to 8.75), keeping women privacy (AOR=2.84; 95%?CI 1.46 to 5.55), planned delivery in the health institution (AOR=2.85; 95%?CI 1.99 to 4.07), duration of labour within 12?hours (AOR=2.55; 95%?CI 1.70 to 3.81) and have not antenatal care follow-up (AOR=4.03; 95%?CI 2.21 to 7.35) were factors associated with women satisfaction with labour and delivery services in Ethiopia. CONCLUSION:The pooled prevalence of women's satisfaction with existing labour and delivery services was high. Informal education of the women, antenatal care follow-up, planned delivery in the health institution, keeping women privacy, getting free service, time to be seen by the healthcare providers and duration of labour were factors associated with women's satisfaction during labour and delivery services. This finding is important to design strategic policies and to prevent emergency neonatal and women complications during the childbirth and postpartum periods. PROSPERO REGISTRATION NUMBER:CRD42020149217.

SUBMITTER: Demis A

PROVIDER: S-EPMC7380852 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Women's satisfaction with existing labour and delivery services in Ethiopia: a systematic review and meta-analysis.

Demis Asmamaw A Getie Addisu A Wondmieneh Adam A Bimerew Melaku M Alemnew Birhan B Gedefaw Getnet G

BMJ open 20200723 7

<h4>Objective</h4>To estimate the pooled prevalence of women's satisfaction with existing labour and delivery services in Ethiopia.<h4>Design</h4>Systematic review and meta-analysis.<h4>Methods</h4>MEDLINE/PubMed, Scopus, Hinari, Google Scholar and web of science electronic databases were searched for the study. This meta-analysis included nineteen cross-sectional studies. Cochrane I<sup>2</sup> statistics were used to check the heterogeneity of the studies. Subgroup and sensitivity analysis wer ...[more]

PMID: 32709648

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Project description:Evidence of variation in maternity health service practices has increased the government's interest in quantifying and advancing the quality of institutional delivery care in the developing world, including Ethiopia. Therefore, we conducted a systematic review and meta-analysis to update and provide more representative data on women's satisfaction with skilled delivery care and the associated factors in Ethiopia. This systematic review and meta-analysis followed the Preferred Reporting Items 2015 guideline. We searched PubMed/Medline, SCOPUS, Embase, Web of Science, and Google Scholar electronic databases for all 36 included studies. The pooled prevalence of women's satisfaction with skilled delivery care and the associated factors were estimated using a random-effects model. Subgroup analysis and meta-regression were performed to identify the source of heterogeneity. Furthermore, publication bias was checked using eggers and funnel plots. All statistical analyses were performed using STATA version 14.0 software. The pooled prevalence of women's satisfaction with skilled delivery care was 67.31 with 95% confidence interval (60.18-74.44). Wanted pregnancy (adjusted odds ratio = 2.86, 95% confidence interval: (2.24-3.64)), having a plan to deliver at a health facility (adjusted odds ratio = 2.09, 95% confidence interval: (1.42-3.09)), access to ambulance service (adjusted odds ratio = 1.52, 95% confidence interval: (1.00-2.31)), waiting time < 15 min (adjusted odds ratio = 3.66, 95% confidence interval: (2.51-5.33)), privacy assured (adjusted odds ratio = 3.94, 95% confidence interval: (2.23-6.94)), short duration of labour < 12 hr (adjusted odds ratio = 2.55, 95% confidence interval: (1.58-4.12)), proper labour pain management (adjusted odds ratio = 3.01, 95% confidence interval: (1.46-6.22)), and normal newborn outcome (adjusted odds ratio = 3.94, 95% confidence interval: (2.17-7.15)) were associated with women's satisfaction. Almost two-thirds of women were satisfied with skilled delivery care. In comparison, the remaining one-third were not satisfied with the care. The quality of intrapartum care, unwanted pregnancy, lack of ambulance services, prolonged duration of labour, poor labour pain management, and complicated newborn outcome were factors affecting women's satisfaction with skilled delivery care in Ethiopia. Therefore, strategies need to be developed to increase the satisfaction level by considering the abovementioned factors during routine delivery care.

Project description:BackgroundMothers' satisfaction with care during childbirth is indicators of the quality care which affects skilled birth attendance. Negative client's experiences at health facilities cause them to delay or avoid seeking care, which highlights services providers should consider and act on the expectations and experiences of women and their families. Though there are few studies conducted in Ethiopia on maternal satisfaction with Labor and Delivery (LAD) services, there is no study conducted in the study area. Therefore the study aims to assess the mother's satisfaction with existing LAD services and associated factors at all levels of health care in the West Shewa zone.MethodsAn institution-based cross-sectional study was conducted at public health facilities in West Shewa zone, Central Ethiopia. A systematic sampling technique was used to select 560 respondents by using their delivery registration number and data were collected through face to face interview. Mothers were considered satisfied if they responded satisfied/very satisfied with 75% or more of the questions assessing satisfaction. Binary and multivariable logistic regression analysis was used to identify associated factors.ResultsThe overall proportion of mothers who were satisfied with the current LAD care services were 60.8%. The main areas of dissatisfaction were; accessibility and cleanness of toilets/shower 72.6%, overall cleanness of the facility/including waiting-area 40.1% and presence of support a person during birth 38.0%. The presence of cultural practices (AOR = 2.5), discussion on the place of delivery with health worker during ANC (AOR = 1.75), providers asks for consent before procedure (AOR = 2.77), encouraging companion to remain with mother (AOR = 2.22), never leave mother alone or unattended (AOR = 2.56), giving periodic updates on status and progress of labor (AOR = 2.04) and explaining what is being done and to expect during LAD (AOR = 2.20) were factors identified to be significantly associated with satisfaction on LAD services.ConclusionThe overall satisfaction of mothers with LAD services at public health facilities in the West-Shewa zone was relatively low. Presence of cultural practices, discussion on the place of delivery, asking for consent before the procedure, encouraging companion to remain with mothers and explaining what is being done were factors identified. Therefore, all stakeholders have to emphatically work on those identified factors to improve mothers' satisfaction with LAD services.

Project description:BackgroundAccording to the 2015 World Health Organization report, globally, an estimated 10.7 million mothers died from 1990 to 2015 due to obstetric complications. This report showed that almost all global maternal deaths (99%) occurred in developing countries and two thirds of these deaths took place in sub-Saharan Africa where the majority of women lack knowledge about obstetric danger signs. In Ethiopia, in several research reports, it has been indicated that women have poor knowledge about obstetric danger signs. Although several studies have been conducted to assess women's knowledge of obstetric danger signs, to date, no systematic review has been conducted in Ethiopia. Therefore, this review is aimed at synthesising the existing literature about women's knowledge of obstetric danger signs.MethodsWe systematically searched for articles from MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, Web of Science, Scopus, Google Scholar and Maternity and Infant Care databases. A combination of search terms including 'knowledge' or 'awareness' or 'information' and 'pregnancy danger signs' or 'obstetric danger signs' or 'obstetric warning signs' and 'Ethiopia' was used to locate appropriate articles. Two reviewers conducted article screening and data abstraction independently. Observational studies published in English and conducted in Ethiopia to date were assessed for quality using the adapted Newcastle Ottawa Scale for cross-sectional studies. The PRISMA checklist was used to present the findings of this systematic review.ResultsFrom the 215 articles initially screened by abstracts and titles, 12 studies fulfilled the inclusion criteria. All the studies reported women's knowledge of obstetric danger signs during pregnancy, ten articles reported on the level of knowledge during delivery and eight studies reported on the level of knowledge of danger signs during the postpartum period. The pooled random effect meta-analysis level of women's knowledge about obstetric danger signs during pregnancy, delivery and postpartum was 48%, 43% and 32%, respectively. Maternal age, education, income, health service use, distance from facility and women's autonomy were reported in several studies as determinants of women's knowledge of obstetric danger signs.ConclusionsWomen's knowledge about obstetric danger signs in Ethiopia was very poor, which could hamper access to obstetric care when women encounter obstetric complications. Counselling services during antenatal care and community-based health information dissemination about obstetric danger signs should be strengthened.Systematic review registrationPROSPERO CRD42017077000.

Project description:BackgroundPost-partum haemorrhage occurs in over 10% of all births and is the leading cause of maternal mortality, accounting for 25% of all maternal deaths worldwide. Active management of the third stage of labor is the most important intervention for reducing maternal morbidity and mortality by preventing postpartum hemorrhage. Previously, documented primary studies had been great discrepancy, inconsistent results, and there is a lack of comprehensive study. Hence, this systematic review and meta-analysis were intended to assess the prevalence and associated factors of the practice of active management of the third stage of labour among obstetric care providers in Ethiopia.MethodCross-sectional studies were systematically searched from January 01, 2010, to December 24, 2020, using PubMed, Google Scholar, HINARI, Cochrane Library, and grey literature. The pooled prevalence of active management of the third stage of labour practice and associated factors was estimated using DerSemonial-Laird Random Effect Model. Stata (version 16.0) was used to analyze the data. The I-squared statistic was used to assess the studies' heterogeneity. A funnel plot and Egger's test were used to check for publication bias. A subgroup analysis was performed to minimize the underline heterogeneity depending on the study years and the sample sizes.ResultsSeven hundred fifty articles were extracted. The final ten studies were included in this systematic review, including 2438 participants. The pooled prevalence of practices of active management of the third stage of labour among obstetric care providers in Ethiopia was 39.65% (30.86, 48.45%). Educational status (OR = 6.11, 95%CI, 1.51-10.72), obstetric care training (OR = 3.56, 95% CI: 2.66, 4.45), work experience (OR = 2.17, 95%CI, 0.47, 3.87) and knowledge of active management of the third stage of labour (OR = 4.5, 95% CI: 2.71, 6.28) were significantly associated with active management of the third stage of labour practices.ConclusionThe practice of active management of the third stage of labour in Ethiopia was low. This study showed that educational status, taking obstetric care training, knowledge of AMTSL, and work experience of obstetric care providers were associated with of practices of active management of the third stage of labour. Therefore, obstetric care professionals should improve their academic level, knowledge, and skills in order to provide useful service to AMTSL and save mothers' lives. All obstetric care providers should get obstetric care training. Furthermore, the government should increase obstetric care professionals' educational level.

Project description:BackgroundHealth professional's job satisfaction is directly related to patient satisfaction and quality of care. Without satisfied health professionals the health system is not functional, and the national and global health related plans are not achieved. However, little is known on the level of health professional's job satisfaction in sub Saharan African countries including Ethiopia. In addition, in Ethiopia there is no summarized evidence helped us an input to design strategies. Therefore, we aimed to assess the pooled prevalence of health professional's job satisfaction and its determinants in Ethiopia.MethodsArticles were searched from PubMed, PsycINFO, Hinari, Science Direct, web of science and African journal of online (AJOL) databases, Google and Google scholar. A standardized Microsoft excel spread sheet and STATA software version 16 were used for data extraction and analysis respectively. We followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis to write this report. A random effect meta-analysis model was used to determine the pooled prevalence of job satisfaction. I2 was done to check heterogeneity. Egger's test and funnel plot were conducted to detect publication bias. Subgroup analysis was also conducted. Association was expressed through pooled odd ratio with a 95% CI.ResultIn this review and meta-analysis, a total of 29 studies were included. The pooled prevalence of health professional's job satisfaction was 46.17% [95% CI (43.08, 49.26)]. The heterogeneity and publication bias test results were I2 = 87.3%, P < 0.001 and Eggers', P = 0.16. Female sex; OR: 2.20 [95% CI (1.63, 2.97)], working environment; OR: 9.50 [95% CI (6.25, 14.44)], opportunity for professional growth and development; OR: 5.53 [95% CI (1.56, 19.56)], staff relationship; OR: 3.89 [95% CI (1.65, 9.17)] and supportive supervision; OR: 5.32 [95% CI (1.77, 15.92)] were associated with health professional's job satisfaction.ConclusionMore than half of professionals were dissatisfied with their jobs. Therefore, the ministry of health and stakeholders better to design strategies to increase the level of satisfaction. Furthermore, it is better to strengthen staff relationship and making the working environment more attractive and equipped.

Dataset Information

Women's satisfaction with existing labour and delivery services in Ethiopia: a systematic review and meta-analysis.

Publications

Women's satisfaction with existing labour and delivery services in Ethiopia: a systematic review and meta-analysis.

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