IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v71y2010i10p1739-1748.html
   My bibliography  Save this article

Assessing and understanding quality of care in a labour ward: A pilot study combining clinical and social science perspectives in Gondar, Ethiopia

Author

Listed:
  • Pitchforth, Emma
  • Lilford, Richard J.
  • Kebede, Yigzaw
  • Asres, Getahun
  • Stanford, Charlotte
  • Frost, Jodie

Abstract

Ensuring high quality intrapartum care in developing countries is a crucial component of efforts to reduce maternal and neonatal mortality and morbidity. Conceptual frameworks for understanding quality of care have broadened to reflect the complexity of factors affecting quality of health care provision. Yet, the role of social sciences within the assessment and understanding of quality of care in this field has focused primarily on seeking to understand the views and experiences of service users and providers. In this pilot study we aimed to combine clinical and social science perspectives and methods to best assess and understand issues affecting quality of clinical care and to identify priorities for change. Based in one referral hospital in Ethiopia, data collection took place in three phases using a combination of structured and unstructured observations, interviews and a modified nominal group process. This resulted in a thorough and pragmatic methodology. Our results showed high levels of knowledge and compliance with most aspects of good clinical practice, and non-compliance was affected by different, inter-linked, resource constraints. Considering possible changes in terms of resource implications, local stakeholders prioritised five areas for change. Some of these changes would have considerable resources implications whilst others could be made within existing resources. The discussion focuses on implications for informing quality improvement interventions. Improvements will need to address health systems issues, such as supply of key drugs, as well as changes in professional practice to promote the rational use of drugs. Furthermore, the study considers the need to understand broader organizational factors and inter-professional relationships. The potential for greater integration of social science perspectives as part of currently increasing monitoring and evaluation activity around intrapartum care is highlighted.

Suggested Citation

  • Pitchforth, Emma & Lilford, Richard J. & Kebede, Yigzaw & Asres, Getahun & Stanford, Charlotte & Frost, Jodie, 2010. "Assessing and understanding quality of care in a labour ward: A pilot study combining clinical and social science perspectives in Gondar, Ethiopia," Social Science & Medicine, Elsevier, vol. 71(10), pages 1739-1748, November.
    • Handle: RePEc:eee:socmed:v:71:y:2010:i:10:p:1739-1748
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(10)00606-4
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Lindelow, Magnus & Serneels, Pieter, 2006. "The performance of health workers in Ethiopia: Results from qualitative research," Social Science & Medicine, Elsevier, vol. 62(9), pages 2225-2235, May.
    2. Bentley, Margaret E. & Pelto, Gretel H. & Straus, Walter L. & Schumann, Debra A. & Adegbola, Catherine & de la Pena, Emanuela & Oni, Gbolahan A. & Brown, Kenneth H. & Huffman, Sandra L., 1988. "Rapid ethnographic assessment: Applications in a diarrhea management program," Social Science & Medicine, Elsevier, vol. 27(1), pages 107-116, January.
    3. Garcia-Goni, Manuel & Maroto, Andres & Rubalcaba, Luis, 2007. "Innovation and motivation in public health professionals," Health Policy, Elsevier, vol. 84(2-3), pages 344-358, December.
    4. Leonard, Kenneth & Masatu, Melkiory C., 2006. "Outpatient process quality evaluation and the Hawthorne Effect," Social Science & Medicine, Elsevier, vol. 63(9), pages 2330-2340, November.
    5. Dixon-Woods, Mary & Suokas, Anu & Pitchforth, Emma & Tarrant, Carolyn, 2009. "An ethnographic study of classifying and accounting for risk at the sharp end of medical wards," Social Science & Medicine, Elsevier, vol. 69(3), pages 362-369, August.
    6. Hulton, Louise Anne & Matthews, Zoë & Stones, Robert William, 2007. "Applying a framework for assessing the quality of maternal health services in urban India," Social Science & Medicine, Elsevier, vol. 64(10), pages 2083-2095, May.
    7. Raman, Parvathy & Mavalankar, Dileep & Jain M L & Dwivedi Hemant, 2004. "Managing Equipment for Emergency Obstetric Care in Rural Hospitals," IIMA Working Papers WP2004-03-08, Indian Institute of Management Ahmedabad, Research and Publication Department.
    8. Zaman, Shahaduz, 2004. "Poverty and violence, frustration and inventiveness: hospital ward life in Bangladesh," Social Science & Medicine, Elsevier, vol. 59(10), pages 2025-2036, November.
    9. Sakala, Carol, 1993. "Midwifery care and out-of-hospital birth settings: How do they reduce unnecessary cesarean section births?," Social Science & Medicine, Elsevier, vol. 37(10), pages 1233-1250, November.
    10. McKendry, Rachael & Langford, Tom, 2001. "Legalized, regulated, but unfunded: midwifery's laborious professionalization in Alberta, Canada, 1975-99," Social Science & Medicine, Elsevier, vol. 53(4), pages 531-542, August.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Gili Hrusa & Mark Spigt & Tariku Dejene & Solomon Shiferaw, 2020. "Quality of Family Planning Counseling in Ethiopia: Trends and determinants of information received by female modern contraceptive users, evidence from national survey data, (2014- 2018)," PLOS ONE, Public Library of Science, vol. 15(2), pages 1-18, February.
    2. Vestering, Asra & de Kok, Bregje C. & Browne, Joyce L. & Adu-Bonsaffoh, Kwame, 2021. "Navigating with logics: Care for women with hypertensive disorders of pregnancy in a tertiary hospital in Ghana," Social Science & Medicine, Elsevier, vol. 289(C).
    3. Arnold, Rachel & van Teijlingen, Edwin & Ryan, Kath & Holloway, Immy, 2018. "Parallel worlds: An ethnography of care in an Afghan maternity hospital," Social Science & Medicine, Elsevier, vol. 216(C), pages 33-40.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Brock, J. Michelle & Lange, Andreas & Leonard, Kenneth L., 2018. "Giving and promising gifts: Experimental evidence on reciprocity from the field," Journal of Health Economics, Elsevier, vol. 58(C), pages 188-201.
    2. Leonard, Kenneth L., 2009. "The cost of imperfect agency in health care: Evidence from rural Cameroun," Journal of Development Economics, Elsevier, vol. 88(2), pages 282-291, March.
    3. World Bank Group, 2012. "Understanding Access to Justice and Conflict Resolution at the Local Level in the Central African Republic," World Bank Publications - Reports 16097, The World Bank Group.
    4. Biswas, Debashish & Hossin, Raduan & Rahman, Mahbubur & Bardosh, Kevin Louis & Watt, Melissa H. & Zion, Mazharul Islam & Sujon, Hasnat & Rashid, Md Mahbubur & Salimuzzaman, M. & Flora, Meerjady S. & Q, 2020. "An ethnographic exploration of diarrheal disease management in public hospitals in Bangladesh: From problems to solutions," Social Science & Medicine, Elsevier, vol. 260(C).
    5. Woo-Sung Choi & Seung-Wan Kang & Suk Bong Choi, 2022. "Creativity in the South Korean Workplace: Procedural Justice, Abusive Supervision, and Competence," IJERPH, MDPI, vol. 19(1), pages 1-16, January.
    6. Edward N. Okeke & Amalavoyal V. Chari, 2015. "Can Institutional Deliveries Reduce Newborn Mortality? Evidence from Rwanda," Working Papers WR-1072, RAND Corporation.
    7. Tafesse, Wiktoria & Chalkley, Martin, 2021. "Faith-based provision of sexual and reproductive healthcare in Malawi," Social Science & Medicine, Elsevier, vol. 282(C).
    8. Fuhai Hong & Tanjim Hossain & John A. List & Migiwa Tanaka, 2018. "Testing The Theory Of Multitasking: Evidence From A Natural Field Experiment In Chinese Factories," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 59(2), pages 511-536, May.
    9. World Bank, 2007. "Ethiopia : Enhancing Human Development Outcomes Through Decentralized Service Delivery," World Bank Publications - Reports 7711, The World Bank Group.
    10. Jelnov, Artyom & Jelnov, Pavel, 2022. "Vaccination policy and trust," Economic Modelling, Elsevier, vol. 108(C).
    11. Danila Serra & Pieter Serneels & Magnus Lindelow & Jose G. Montalvo, 2010. "Discovering the Real World : Health Workers' Career Choices and Early Work Experience in Ethiopia," World Bank Publications - Books, The World Bank Group, number 5936, December.
    12. Taufique Joarder & Asha George & Syed Masud Ahmed & Sabina Faiz Rashid & Malabika Sarker, 2017. "What constitutes responsiveness of physicians: A qualitative study in rural Bangladesh," PLOS ONE, Public Library of Science, vol. 12(12), pages 1-19, December.
    13. Thune, Taran & Mina, Andrea, 2016. "Hospitals as innovators in the health-care system: A literature review and research agenda," Research Policy, Elsevier, vol. 45(8), pages 1545-1557.
    14. Ellen Poel & Owen O'donnell & Eddy Doorslaer, 2009. "What explains the rural-urban gap in infant mortality: Household or community characteristics?," Demography, Springer;Population Association of America (PAA), vol. 46(4), pages 827-850, November.
    15. Nazmul Alam & Mohammad Hajizadeh & Alexandre Dumont & Pierre Fournier, 2015. "Inequalities in Maternal Health Care Utilization in Sub-Saharan African Countries: A Multiyear and Multi-Country Analysis," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-16, April.
    16. Richard A Iles, 2018. "Informal healthcare sector and marginalized groups: Repeat visits in rural North India," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-14, July.
    17. Sherry Dahlke & Kathleen F. Hunter & Kelly Negrin & Maya Reshef Kalogirou & Mary Fox & Adrian Wagg, 2019. "The educational needs of nursing staff when working with hospitalised older people," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(1-2), pages 221-234, January.
    18. Edwin van Teijlingen, 2005. "A Critical Analysis of the Medical Model as used in the Study of Pregnancy and Childbirth," Sociological Research Online, , vol. 10(2), pages 63-77, July.
    19. Margaret E. Kruk & Adanna Chukwuma & Godfrey Mbaruku & Hannah H. Leslie, 2017. "Variation in quality of primary-care services in Kenya, Malawi, Namibia, Rwanda, Senegal, Uganda and the United Republic of Tanzania," WIDER Working Paper Series wp-2017-139, World Institute for Development Economic Research (UNU-WIDER).
    20. Puertas, Rosa & Marti, Luisa & Guaita-Martinez, José M., 2020. "Innovation, lifestyle, policy and socioeconomic factors: An analysis of European quality of life," Technological Forecasting and Social Change, Elsevier, vol. 160(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:71:y:2010:i:10:p:1739-1748. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.