Prompt Attention: Labour and Childbirth Services and Maternal Complications in Two Referral Hospitals in Tanzania

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School of Nursing and Midwifery, East Africa


Background: Prompt attention is one of the eight non-medical domains used to evaluate healthcare and is considered the most important domain for maternal healthcare. Prompt attention includes short travel and waiting times (within 1 hour) to support good health outcomes. This study aimed to determine the impact of prompt attention (as measured by travel and waiting times) on labour and childbirth services in two Tanzanian referral hospitals between October and November 2014.

Methods: Simple random sampling was used to recruit 163 mothers within 48 hours post-partum; 81 from Haydom Lutheran Referral Hospital and 82 from Mwananyamala Referral Hospital. Data were collected using a structured interviewer-administered questionnaire. Frequency distribution tables and figures were generated and Pearson’s chi-square tests were used to examine the relationships between travel and waiting times and maternal complications. P-values < 0.05 were considered statistically significant.

Results: The majority (n = 102, 62.6%) of participants travelled to the healthcare facility within 1 hour. However, 61 (37.4%) travelled for more than 1 hour. At both facilities, most participants (n = 161, 98.8%) waited less than 1 hour to be attended. Although 64.5% (n = 104) of the women who were attended within 1 hour did not develop maternal complications after childbirth, although 35.4% (n = 59) developed maternal complications. In addition, 71 (69.6%) of the 102 women who travelled to the health facility within 1 hour did not develop maternal complications.

Conclusion: There were insufficient data to detect a real difference in the association between waiting times and complications between the two hospitals. However, greater travelling time was statistically significantly associated with maternal complications in both hospitals. The reported complications might have been attributable to delays in deciding to access healthcare before labour. Further studies on this topic are needed, including qualitative research that explores mothers’ perspectives.

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