An evaluation of perinatal services in institutions in Jamaica

RESUMO

An evaluation of perinatal services in institutions was undertaken as part of the perinatal morbidity and mortality survey of Jamaica 1986-1987. Observations were made of obstetric practice and immediate neonatal care on five randomly selected days during September and October 1986 using a standard questionnaire based on the WHO guidelines on appropriate technology for birth. Of 140 deliveries 18 per cent (95 per cent CI 12 per cent - 25 per cent) were unattended (i.e. head not controlled on the perineum). Median bed utilisation was 68 per cent with a range of 0 - 93 per cent. Thirty-five per cent of institutions had maternity beds with more than one patient to a bed. Only 7 per cent of babies were put to the breast immediately following delivery and 47 per cent within two hours. Eighty-four per cent of newborns received adequate cord care. There was a shortage of nursing staff with 53 per cent, 77 per cent, 82 per cent, and 86 per cent of registered nurses and midwifery posts filled at CRH, VJH, Spanish Town Hospital and UHWI respectively. The findings indicate the need for immediate measures to improve the standard of care.