Wafa Abu jaber
European Gaza Hospital, Palestine
Title: The quality of postpartum care at governmental hospitals in the Gaza strip: Challenges and implications
Biography
Biography: Wafa Abu jaber
Abstract
Health services provided to mothers after delivery constitute an essential component of the maternal and child health services in any population. According to Palestinian Ministry of Health (MOH) maternal mortality rate (MMR) in the Gaza-Strip was 30/100,000 live births in 2014, and 25 in 2015 ,which differed from that in the West Bank with 20/100, 000 in 2014 (Bottcher et al., 2018).
The aim of the study was to assess the quality of postpartum care provided at governmental hospitals in Gaza Strip and to assess mothers’ satisfaction with postpartum care. The study took place from May 2018 to March 2019, and the researcher used descriptive, analytical, cross sectional design. The sample of the study consisted of 115 nurses and midwives who are working in postpartum departments (Normal vaginal Delivery NVD units and Cesarean Section CS units) at governmental hospitals (Al Shifa hospital, Nasser hospital, Shohada Al Aqsa hospital, and Al Emaratey hospital), and 428 postpartum mothers from the same hospitals, the researcher chose this sample according the mean number of 2016 and 2017 cases. For data collection, the researcher developed three instruments: Quality of postpartum care (A nursing perspective), mothers' satisfaction from by/about postpartum care, and observational checklist for nursing care. trained nurses helped us the researchers in collecting data. Reliability of the questionnaire was tested and Cronbache alpha coefficient was 0.965 for satisfaction scale, and 0.852 for quality of postpartum care. For data analysis, SPSS (version 22) was used, and statistical analysis included frequencies, percentage, means, standard deviation, (t) test, and One way ANOVA.
The results showed that the mean age of mothers was 26.32±5.86 years, 93.2% were housewives, 6.8% were working mothers, 30.1% primiparous, in addition, mean age of nurses was 30.96±6.007 years, (60.9%) had Bachelor degree,41.7% had 6-10years of experience. The results showed that 18.9% of mothers were highly satisfied and 53% were satisfied, and the mothers expressed above moderate satisfaction with mean score 3.78 and weighted percentage (75.6%). There were no statistically significant differences in mothers’ satisfaction related to age, work-status and number of deliveries. In addition, the results indicated high quality postpartum care (Nurses and midwives perspective) 90% in governmental hospitals in Gaza Strip. There were statistically significant differences in the perception of the quality of postpartum care based upon years of experience, where nurses and midwives with 1 - 5 years of experience have had the lowest mean score in providing quality of care, but there were no significant differences in quality of postpartum care related to nurses’ age and qualification. Furthermore, in observational checklists results, the highest score was in communication with mean score 2.56 and weighted percentage 85.3%, and the lowest score was in efficient care of the baby with mean score 1.95 and weighted percentage 65%. The overall score of observed performance was above moderate with mean score 2.02 and weighted percentage 67.3 %. Also the researcher presented the challenges to improve mothers' satisfaction with Postpartum care (PPC) and the implications to improve the quality of PPC . In conclusion, according to the weakest points of postpartum care (A nursing perspective) the study raised the need to apply Palestinian unified, written protocols and guidelines that specify and describes nurses’ interventions during the postpartum period for the mother and her baby.