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Quality of care in MNH care services

Experiences of disrespect and abuse during childbirth might be one of the major reasons for remaining low figures of skilled birth attendance despite all global efforts to increase accessibility, affordability, acceptability and quality of care. It remains unclear however what the scope is of the problem, to what extent it affects care seeking and which factors can potentially change it.

Photo: Mante Sliepen

About the project

This project is inspired by a determination to improve quality of maternity care for women living in remote areas most at risk for adverse pregnancy outcomes. Quality of care received during pregnancy and childbirth in low-resource settings, such as Tanzania, is reported to be of low quality due to lack of (human) resources or knowledge and skills of health providers. Although limited, there are also reports that highlight substandard or unfriendly care provided by healthcare workers.

Quality of care during pregnancy and childbirth has long focussed on the technical aspects of care leaving out the fundamental quality of ‘caring’. It is increasingly acknowledged that women’s perceptions of the quality of care are likely to influence their choice to seek care and might explain remaining low figures of women who give birth in the presence of a skilled doctor or midwife.

This project aims to gain additional knowledge on how perceptions of quality, and in particular the interpersonal quality of care influence care seeking and how this potentially could be improved.   It is a multidisciplinary effort to promote and facilitate better quality care for pregnant women at basic, low level health facilities in a rural district in Tanzania.

Objectives

Primary objective

To increase knowledge on how the interpersonal quality of care provided by facility based health care workers during pregnancy and childbirth in rural health facilities in Tanzania influences care seeking

Secondary objectives

  1. To understand how women in rural communities in Tanzania experience care received during pregnancy and childbirt
  2. To develop a tool to measure the interpersonal quality of care provided by health care workers during pregnancy and childbirth in the context of rural Tanzania
  3. To assess and describe the effects of community participation in decision making around health care seeking behavior on care provision during pregnancy and childbirth in rural Tanzania
  4. To understand how enhanced dialogue between health care workers and community members in rural communities in Tanzania about pregnancy and childbirth practices affects care utilization
  5. To assess the relation between the interpersonal and the technical quality of care in pregnancy and childbirth
  6. To assess which factors of the quality of care provided by facility based health care workers during pregnancy influences care seeking during childbirth

Publications

  • Solnes Miltenburg A, Rijkers E, Maselle N, Barass J, van Roosmalen J, Bunders J. Reflections of the dynamics of the coexistence of multiple knowledge cultures in a community-based maternal health project in Tanzania. Knowledge Management for Development Journal 9(2):158-180

Background

We will apply a design based on mixed methods, both qualitative and quantitative. This will be survey tools as well as interviews and semi-participatory methods. This project additionally aims to develop a tool for measuring the interpersonal quality of care in this context. This will then be used as a tool to measure the effect of the community participatory intervention on increasing quality of care.

Read more about methods and the interdisciplinary approach in this project.

Sub-Projects

  1. Collecting data on the quality of care provision during pregnancy and childbirth
  2. Community group intervention activities related to quality of care
  3. Collecting prospective data on pregnancy and birth

Financing

  • Globvac grant 2015

Cooperation

  • Catholic University of Health and Allied Sciences
  • African Woman Foundation

Start - finish

2015 - 2018

Tags: Global South
Published Feb. 13, 2015 3:50 PM - Last modified June 24, 2016 12:33 PM

Contact

Project leader: Johanne Sundby

Participants

Detailed list of participants