Mamadou Traoré1, Catherine Arsenault2, Camille Schoemaker-Marcotte2, Aliou Coulibaly2, Cyrille Huchon3, Alexandre Dumont4, Pierre Fournier5. 1. URFOSAME, Faculté de Médecine, Université de Bamako, Bamako, Mali. 2. Axe de Santé Mondiale, CRCHUM, Université de Montréal, Montréal, Canada. 3. Axe de Santé Mondiale, CRCHUM, Université de Montréal, Montréal, Canada; Centre de recherche du CHU Sainte Justine, Montréal, Canada. 4. Unité 216, Institut de recherche pour le développement, Paris, France. 5. Axe de Santé Mondiale, CRCHUM, Université de Montréal, Montréal, Canada. Electronic address: pierre.fournier@umontreal.ca.
Abstract
OBJECTIVE: To determine individual and contextual factors associated with emergency obstetric and neonatal care (EmONC) competency among primary healthcare staff in Mali. METHODS: Between November 2011 and April 2012, a competency test was administered to 196 healthcare workers in 65 community health centers in Mali. The test was scored from 0 to 100, and differences among 5 areas of EmONC were assessed. A multilevel linear regression model was used to determine individual and contextual factors associated with score. RESULTS: The mean score was 66.7 (minimum, 15.9; maximum, 97.7). Knowledge was most deficient for postpartum infection and hypertensive complications. Type of health worker, years of experience, number of days absent, and availability of guidelines for management of obstetric complications within the health center were positively associated with test score (P<0.05). Availability of guidelines was associated with higher competency of physicians, health technicians, and obstetric nurses (P<0.001), and seemed to influence the competency of healthcare workers with fewer than 10 years of experience in particular. CONCLUSION: Guidelines must be developed that will facilitate standardization of the management of postpartum infection and other less common complications for which healthcare workers show low competence. Strategies to increase use of these guidelines will be necessary.
OBJECTIVE: To determine individual and contextual factors associated with emergency obstetric and neonatal care (EmONC) competency among primary healthcare staff in Mali. METHODS: Between November 2011 and April 2012, a competency test was administered to 196 healthcare workers in 65 community health centers in Mali. The test was scored from 0 to 100, and differences among 5 areas of EmONC were assessed. A multilevel linear regression model was used to determine individual and contextual factors associated with score. RESULTS: The mean score was 66.7 (minimum, 15.9; maximum, 97.7). Knowledge was most deficient for postpartum infection and hypertensive complications. Type of health worker, years of experience, number of days absent, and availability of guidelines for management of obstetric complications within the health center were positively associated with test score (P<0.05). Availability of guidelines was associated with higher competency of physicians, health technicians, and obstetric nurses (P<0.001), and seemed to influence the competency of healthcare workers with fewer than 10 years of experience in particular. CONCLUSION: Guidelines must be developed that will facilitate standardization of the management of postpartum infection and other less common complications for which healthcare workers show low competence. Strategies to increase use of these guidelines will be necessary.
Authors: Kim Jonas; Priscilla Reddy; Bart van den Borne; Ronel Sewpaul; Anam Nyembezi; Pamela Naidoo; Rik Crutzen Journal: BMC Health Serv Res Date: 2016-11-15 Impact factor: 2.655
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