Quality Aspects of Maternal Health Care

This thesis assesses some indicators of quality for maternity care, using antenatal management of anaemia and hypertension and emergency obstetric care as focal points. The care of pregnant women consecutively enrolled in antenatal care (n=379) was observed and compared with quality standard criteria. From a tertiary level labour ward 741 cases of eclampsia were identified and their antenatal care analyzed. A health systems analysis was performed for 205 cases of pregnancy complications at district level.There was inadequate equipment and drugs, inadequate staff knowledge and motivation, and incorrect measurements for investigating anaemia and hypertension in pregnancy. Hospital incidence of eclampsia at tertiary level was 200/10,000 live births, and was not modified by antenatal care. The quality observed in the antenatal programme indicated little impact on either anaemia or hypertensive complications. Compliance with obstetric referral was only 46% and all four observed maternal deaths occurred due to transport problems. The proposed process indicators for essential obstetric care were inadequate to assess the quality of care on a district level…


Maternal health care and the increasing need for the quality assessment and improvement
Concept of quality in health care
Determinants of quality of care
Assessment of quality of health care
Evidence of effectiveness of antenatal interventions
Implementations of interventions according to specified standards
Information on Tanzania, the rationale and objectives of the study
Rationale of the study
Aim of the study
Specific objectives
Subjects and methods
Study setting
Study population and sampling
Data collection
Standards and definitions
Statistical methods
Ethical considerations
Structural quality
Process quality
Outcome quality
General discussion
Methodological consideration
Structure quality
Human resources
Process quality
Outcome quality
Summary – conclusions and recommendations
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Special thanks in Tanzania to

Author: Urassa, David Paradiso

Source: Uppsala University Library

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