Factors associated with the awareness and practice of evidence-based obstetric care in an African setting.
BJOG
; 113(9): 1060-6, 2006 Sep.
Article
em En
| MEDLINE
| ID: mdl-16956337
ABSTRACT
OBJECTIVE:
To identify the factors associated with important (> or =50%) variation in awareness and practice of evidence-based obstetric interventions in an African setting where we have previously reported poor awareness and use of evidence-based reproductive interventions.DESIGN:
Cross-sectional analysis of data from our Reproductive Health Interventions Study.SETTING:
North-west province, Cameroon, Africa. POPULATION Health workers including obstetricians, other physicians, midwives, nurses and other staff providing reproductive care. MAIN OUTCOMEMEASURES:
Prevalence ratios (PR) of uniform awareness and practice of four key evidence-based obstetric interventions from the World Health Organization Reproductive Health Library (WHO RHL) antiretrovirals to prevent mother-to-child transmission of HIV/AIDS, antenatal corticosteroids for prematurity, uterotonics to prevent postpartum haemorrhage and magnesium sulphate for seizure prophylaxis.METHODS:
Comparisons of descriptive covariates, applying logistic regression to estimate independent relationships with awareness and use of evidence-based interventions.RESULTS:
A total of 15.5% (50/322) of health workers were aware of all the four interventions while only 3.8% (12/312) reported optimal practice. Evidence-based awareness was strongly associated with practice (PR = 15.4; 96% CI 4.3-55.0). Factors significantly associated with awareness were attending continuing education, access to the WHO RHL, employment as an obstetrician/gynaecologist and working in autonomous military or National Insurance Fund facilities. Controlling for potential confounding, working as an obstetrician was associated with increased awareness (adjusted prevalence odds ratio [aPOR] = 8.3; 95% CI 1.3-53.8) as was median work experience of 5-15 years (aPOR = 2.0; 95% CI 1.0-3.8). Internet access was associated with increased practice (aPOR = 3.4; 95% CI 1.0-11.8). Other potentially important variations were observed, although they did not attain statistical significance.CONCLUSIONS:
Several factors including obstetric training and continuous education positively influence evidence-based awareness and practice of key obstetric interventions. Confirmation and application of this information may enhance the effectiveness of programmes to improve maternal and perinatal outcomes.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
/
5_ODS3_mortalidade_materna
Problema de saúde:
1_geracao_evidencia_conhecimento
/
2_cobertura_universal
/
2_salud_sexual_reprodutiva
/
5_maternal_care
Assunto principal:
Cuidado Pré-Natal
/
Prática Profissional
/
Conhecimentos, Atitudes e Prática em Saúde
/
Pessoal de Saúde
/
Medicina Reprodutiva
/
Medicina Baseada em Evidências
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
/
Pregnancy
País/Região como assunto:
Africa
Idioma:
En
Revista:
BJOG
Assunto da revista:
GINECOLOGIA
/
OBSTETRICIA
Ano de publicação:
2006
Tipo de documento:
Article
País de afiliação:
Estados Unidos