Assessment of immediate postpartum care following uncomplicated vaginal delivery at a district hospital in Dar es salaam

Abstract

Background: The immediate postpartum period is a critical phase in the lives of mothers, where major changes occur and determine their wellbeing. About half of maternal deaths occur within the first 24 hours after delivery, yet it is the most neglected period in terms of provision of immediate postpartum care especially to women who give birth without complication. This study assessed the level of care that was provided in the postpartum ward at Sinza District Hospital Dar es Salaam after uncomplicated virginal birth based on the National postpartum care practice guideline. Materials and Methods: A hospital-based cross-sectional descriptive study involving 427 postpartum mothers receiving immediate postpartum care at Sinza District Hospital. The study was conducted from October to November 2018. Direct observation of the client-provider interactions and face to face exit interviews for clients was conducted. Data were analyzed and cleaned in terms of consistency, checking for outliers and missing data. Descriptive analysis was done using SPSS for windows version 22.0 (2013) Armonk, New York, USA. Continuous variables were summarized using mean and standard deviation. Categorical variables were summarized using proportions. Frequency tables were used to display a summary of the analyzed data. For the purpose of analysis, the items of care were classified into three domains of care, these are maternal assessment, information, and counseling on maternal self-care and postpartum counseling on danger signs. The level of care in each domain and across the domains was categorized as weak, moderate and good. Results: Overall the level of care among all women studied: 0.2% received good care, 61.6% received moderate care and 38.2% received weak care. In domain one all women received a weak level of care regarding maternal assessment, in domain two 87.1%% received good care regarding the information on maternal self-care and in domain three 1.2% received good care as compatible with the provision of information on postpartum danger signs. The average time of hospital stay was 14±5.5 hours and 44.3% stayed for 16 to 24 hours. Conclusion: The majority of women did not receive good immediate postpartum care. Adherence to the National postpartum care guidelines would have shown a good level of care in the immediate postpartum period for this group of postpartum women.