ABSTRACT
Respectful Maternity Care (RMC) charter is one of the tools for ensuring quality of care in maternity services. Nigeria is a signatory to RMC charter; therefore, the charter is expected to be the standard of care. However, in Nigeria and other countries, reports of disrespectful maternity care abound; this discourages women from accessing facility-birth. Therefore, to improve the quality of care towards increase in uptake, it is expedient to assess the level of implementation of the RMC charter by key stakeholders for sustainability, impact and scale-up of charter-compliant maternity care in Nigeria. The study aims to assess the implementation of RMC charter in North-central Nigeria. The study is a mixed-method, cross-sectional study; the expected participants are key stakeholders in healthcare (Healthcare workers, Healthcare Administrators, Project Managers, Policy makers) in North-Central Nigeria (Federal Capital Territory and Kwara state). A multistage sampling technique would be used to enroll participants from 18 healthcare facilities (Primary, Private, Secondary and Tertiary) in rural and urban areas and Ministries of Health officials at local and state government levels. Expected outcomes: The study is expected to provide information on the current status of knowledge and implementation of the RMC charter in Nigeria. It would also identify the enablers and barriers to the implementation process and provide evidence for effective scale-up of the process in Nigeria. The outcomes will be widely disseminated to healthcare workers, health administrators and decision-makers in healthcare services through post-study meetings, conference presentations, journal publications and policy briefs for effective RMC charter implementation in Nigeria.
Subject(s)
Prenatal Care , Quality of Health Care , Delivery of Health Care , Standard of CareABSTRACT
Background: Provision of surgical services at district hospitals (DHS) is cost effective and important. The District Hospital Service Package for South Africa (package of services) specifies the services that a district hospital should provide. The aim of this study was to document the surgical services provided at two DHS in KwaZulu-Natal and to compare this with the recommendations in the package of services. Methods: In a retrospective quantitative study; data from 2008 were collected from the theatre register at two DHS. Data were analysed and results compared with the norms and standards in the package of services. Results were presented to staff at the hospitals; who then commented on the challenges of providing surgical services at DHS. Results: Only 60and 30respectively of procedures listed in the package of services were being carried out at the two hospitals. In total; 3 900 procedures were carried out over the year. Dundee Hospital offered a broader range of surgical procedures and anaesthetics than the Church of Scotland Hospital (COSH). COSH has a large obstetric burden; with 3 666 deliveries each year. A large number of procedures were being carried out by a single operator. Conclusions: Many surgical procedures are being carried out even though neither hospital provides the full complement of surgical services as specified in the package of services. The wide variation between the surgical services offered reflects the surgical and anaesthetic skills at the respective hospitals. Potential medico-legal hazards that require urgent attention were identified. A review of the package of services is essential to identify core procedures that must be provided at DHS