Abstract：
BACKGROUND: Nearly 60% of maternal and 45% of newborn deaths occur within 24 h after delivery. Immediate postpartum monitoring could avert death from preventable causes including postpartum hemorrhage, and eclampsia among mothers, and birth asphyxia, hypothermia, and sepsis for babies. We aimed at assessing facility readiness for the provision of postpartum care within the immediate postpartum period.
METHODS: A cross-sectional study involving 40 health facilities within the greater Mpigi region, Uganda, was done. An adapted health facility assessment tool was employed in data collection. Data were double-entered into Epi Data version 4.2 and analyzed using STATA version 13 and presented using descriptive statistics.
RESULTS: Facility readiness for the provision of postpartum care was low (median score 24% (IQR: 18.7, 26.7). Availability, and use of up-to-date, policies, guidelines and written clinical protocols for identifying, monitoring, and managing postpartum care were inconsistent across all levels of care. Lack of or non-functional equipment poses challenges for screening, diagnosing, and treating postnatal emergencies. Frequent stock-outs of essential drugs and supplies, particularly, hydralazine, antibiotics, oxygen, and blood products for transfusions were more common at health centers compared to hospitals. Inadequate human resources and sub-optimal supplies inhibit the proper functioning of health facilities and impact the quality of postpartum care. Overall, private not-for-profit health facilities had higher facility readiness scores.
CONCLUSIONS: Our findings suggest sub-optimal rural health facility readiness to assess, monitor, and manage postpartum emergencies to reduce the risk of preventable maternal/newborn morbidity and mortality. Strengthening health system inputs and supply side factors could improve facility capacity to provide quality postpartum care.
METHODS: A cross-sectional study involving 40 health facilities within the greater Mpigi region, Uganda, was done. An adapted health facility assessment tool was employed in data collection. Data were double-entered into Epi Data version 4.2 and analyzed using STATA version 13 and presented using descriptive statistics.
RESULTS: Facility readiness for the provision of postpartum care was low (median score 24% (IQR: 18.7, 26.7). Availability, and use of up-to-date, policies, guidelines and written clinical protocols for identifying, monitoring, and managing postpartum care were inconsistent across all levels of care. Lack of or non-functional equipment poses challenges for screening, diagnosing, and treating postnatal emergencies. Frequent stock-outs of essential drugs and supplies, particularly, hydralazine, antibiotics, oxygen, and blood products for transfusions were more common at health centers compared to hospitals. Inadequate human resources and sub-optimal supplies inhibit the proper functioning of health facilities and impact the quality of postpartum care. Overall, private not-for-profit health facilities had higher facility readiness scores.
CONCLUSIONS: Our findings suggest sub-optimal rural health facility readiness to assess, monitor, and manage postpartum emergencies to reduce the risk of preventable maternal/newborn morbidity and mortality. Strengthening health system inputs and supply side factors could improve facility capacity to provide quality postpartum care.
摘要：
背景：近60%的产妇和45%的新生儿死亡发生在分娩后24小时内。立即进行产后监测可以避免因可预防的原因导致的死亡，包括产后出血，和母亲的子痫，出生窒息，体温过低,和婴儿败血症。我们旨在评估设施在产后立即提供产后护理的准备情况。
方法：一项涉及大Mpigi地区40个医疗机构的横断面研究，乌干达，已经完成了。在数据收集中采用了适应性的医疗机构评估工具。将数据双重输入到EpiData版本4.2中，并使用STATA版本13进行分析，并使用描述性统计进行呈现。
结果：设施对提供产后护理的准备程度较低（中位数得分24%（IQR：18.7，26.7）。可用性,和使用最新的，政策,用于识别的指南和书面临床方案，监测,在所有级别的护理中,管理产后护理不一致.缺乏或无功能的设备对筛查构成挑战，诊断,治疗产后紧急情况。基本药物和用品经常缺货,特别是,肼屈嗪,抗生素,氧气,与医院相比，用于输血的血液制品在卫生中心更常见。人力资源不足和供应欠佳，阻碍了保健设施的正常运作，影响了产后护理的质量。总的来说,私营非营利医疗机构的设施就绪评分较高.
结论：我们的研究结果表明，农村卫生机构不理想，监视器,和管理产后紧急情况，以降低可预防的孕产妇/新生儿发病率和死亡率的风险。加强卫生系统投入和供应方因素可以提高设施提供优质产后护理的能力。
方法：一项涉及大Mpigi地区40个医疗机构的横断面研究，乌干达，已经完成了。在数据收集中采用了适应性的医疗机构评估工具。将数据双重输入到EpiData版本4.2中，并使用STATA版本13进行分析，并使用描述性统计进行呈现。
结果：设施对提供产后护理的准备程度较低（中位数得分24%（IQR：18.7，26.7）。可用性,和使用最新的，政策,用于识别的指南和书面临床方案，监测,在所有级别的护理中,管理产后护理不一致.缺乏或无功能的设备对筛查构成挑战，诊断,治疗产后紧急情况。基本药物和用品经常缺货,特别是,肼屈嗪,抗生素,氧气,与医院相比，用于输血的血液制品在卫生中心更常见。人力资源不足和供应欠佳，阻碍了保健设施的正常运作，影响了产后护理的质量。总的来说,私营非营利医疗机构的设施就绪评分较高.
结论：我们的研究结果表明，农村卫生机构不理想，监视器,和管理产后紧急情况，以降低可预防的孕产妇/新生儿发病率和死亡率的风险。加强卫生系统投入和供应方因素可以提高设施提供优质产后护理的能力。
