The Evaluation of Safe Motherhood Project in Community Hospitals of Surin Province in 2004

Abstract

Cause of evaluation: As Government had declared “30 Baht for All Diseases Care” policy according to health insurance scheme., all health facilities have to improve their quality of services to ensure standard services are to be delivered to all people. Surin Provicial Health office had a project to evaluated quality of maternal and child health services according to “Safe Motherhood Project” standard in community hospitals.
Objective: To follow up process and output of project implementation and to certify of services according to safe motherhood hospital standard in community hospitals.
Scope of Evaluation: This study covered factors on knowledge, understanding and practicing of service persons and customers in antenatal care unit, delivery care unit, post partum care unit and newborn unit in community hospital as specified in 11 characteristics.
Place and Time of evaluation: 12 Community hospitals in surin province during August and September 2004
Samples: Samples were divided into 2 groups. The first group included 219 service persons in hospital, who were hospital administrators, head of cluster, workers in antenatal care unit, labour room, postpartum unit and newborn unit. The second group were 107 who were customers of those units.
Evaluation procedures: Interviewing through 4 sets of questionnaires according to group of samples, observation and examining of report documents collected data. Statistics used were percentage and means. Evaluation principle for characteristic number one was 100 percent pass, while other characteristics number 2 to 11 were 75 percent pass.
Findings: Services that were 100 percent passed were: the hospital has clear policy to work out the project. They promoted breastfeeding in labour room. They give post partum care as described in standards. They investigated the cause of maternal and child death. 97.2 percent of customers were satisfied by services of personnel. 92.8% had counselor team for those customer who has maternal and child trouble 91.3% of personnel obtained for their skill training. 87.5% gave standard newborn care. 86.5% of customer had knowledge on maternal and newborn care. 75% got network of continuous care. On the contrary, services that did not pass standard criteria were only 14.3% got standard deliveries. 51.4 % got standard newborn care in labour room. 61.1% got standard antenatal services. 74.3% of pregnant women and husbands were taught in antenatal class while 31.8% of pregnant women joined antenatal class with their cousins.
Conclusion: Data collected pointed out that not any hospital was certifying as safe motherhood hospital. Those hospitals that passed criteria on post partum care were consequence of passing evaluation on Mother and Child Bond hospital. Obstacles found were changing of administrator in some hospital and some new personnel have not been train. All community hospitals have to encourage their personnel to clearly understand those standard procedures for quality services. Instruction manual should be provided for personnel in every unit, especially in delivery unit. Prevention of infection should be well established. Teamwork should be appointed in writing. Satisfaction survey should be conducted in each unit periodically.
Keywords: Safe Motherhood, quality of services, antenatal care, post partum care, delivery care, newborn, community hospital.