article · PLoS ONE
A study conducted across hospitals in Gondar province, northwest Ethiopia, examined how closely healthcare providers adhere to immediate postpartum care guidelines. Assessing 406 healthcare workers through interviews and direct observations between November 2020 and March 2021, the research revealed that only 42.4 percent showed complete adherence to the care standards. Several practical and institutional factors significantly influenced adherence rates. Having a birth assistant, keeping guideline documents readily available in maternity wards, receiving basic emergency obstetric and newborn care training, and earning higher monthly incomes were all associated with better compliance. Being married also increased adherence, whereas possessing six or more years of work experience was linked to lower adherence levels. The findings suggest that staffing levels, specific clinical training, guideline accessibility, and working conditions strongly affect the delivery of immediate postpartum care.
The immediate postpartum period is critical for the survival and health of mothers and newborns, yet it frequently suffers from poor care delivery. Understanding what drives adherence to clinical guidelines helps hospital administrators and policymakers target specific workplace barriers, ensuring mothers and infants receive life-saving interventions during this vulnerable window.
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BACKGROUND: The immediate postpartum period is the most critical time for both the mother and the newborn. However, it is the most neglected part of the maternal continuum of care, and evidence in this regard was scarce in Ethiopia. Therefore, this study aimed to assess the healthcare provider's adherence to immediate postpartum care guidelines and associated factors in hospitals of Gondar province. METHODS: A multicenter observational cross-sectional study was conducted among 406 healthcare providers from 15th November 2020 to 10th March 2021. Data were collected through face-to-face interviews and direct observation using a structured questionnaire and standardized checklist respectively. Data was entered into EPI INFO 7.1.2 and analyzed by SPSS version 25. Both bivariable and multivariable logistic regression analyses were carried out. The level of significance was declared based on the adjusted odds ratio (AOR) with a 95% confidence interval (CI) at a p-value of ≤ 0.05. RESULTS: Overall, 42.4% (95% CI: 37.5, 47.2) of healthcare providers had complete adherence to immediate postpartum care guidelines. Having birth assistant (AOR = 1.87; 95% CI: 1.10, 9.67), being married (AOR = 1.59; 95% CI: 1.15, 3.31), availability of postpartum care guidelines at the maternity ward (AOR = 2.39; 95% CI: 1.44, 3.98), received basic emergency obstetric and newborn care (BEmONC) training (AOR = 2.1; 95% CI: 1.2, 3.6), monthly income of ≥ 10001 Ethiopian birr (AOR = 3.55; 95% CI: 1.30, 9.67), and work experience of ≥ 6 years (AOR = 0.15; 95% CI: 0.06, 0.38) were significantly associated with healthcare providers adherence to immediate postpartum care guidelines. CONCLUSION: This study indicated that health worker's adherence to immediate postpartum care guidelines was low. Hiring adequate health workers, availing postpartum guidelines at the maternity ward, improving the salary and education opportunities for healthcare workers of healthcare workers, and provision of BEmONC training will have a great role in improving healthcare provider's adherence to immediate postpartum care guidelines.
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DOI: 10.1371/journal.pone.0259263
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