Evaluating Quality of Midwifery Care Services in Primary Healthcare Facilities in West Kordofan Region, Western Sudan

Abstract

Background: Providing quality midwifery care services is crucial to reducing maternal morbidity and mortality now and beyond 2030. The maternal mortality ratio (MMR) in the state of West Kordofan is estimated at 121/100,000 Live Births (LB). Evaluating the quality of currently provided midwifery care services will influence the plan to reduce the high MMR. Objectives: To evaluate and measure the quality of midwifery care services provided at primary health facilities in West Kordofan, Sudan. Methods: A cross-sectional community-based study was conducted in West Kordofan state, Sudan. Through this, a total of 291 primary healthcare facilities in seven municipalities and the performance of the corresponding 291 midwives were assessed using the Donabedian framework (Structure, Process, Outcome). To assess the patient-reported outcome measure, 582 patients who served in the selected primary healthcare facilities were surveyed using a five-point Likert scale. Result: The mean ±SD of the age in the midwife’s group was 34.09 ±10.3, while the mean (SD) age of the women was 30.2 ± 7.6. Assessment of the midwife’s performance was effective, expressed in percentages ranging between 75% - 96%. The midwives who received training after graduation were found to be (79.7%), and those who have been recruited in the health system were only (50%). Consumables and essential equipment were found to be adequate, with a comprehensive score of 79.34% and 74.06% respectively. Assessment of the overall women's satisfaction with midwifery revealed that 48% were very satisfied, 25% satisfied, 10% were neutral, 6% dissatisfied, and 11% were very dissatisfied. Conclusion:  The current study showed that the midwifery services provided in the state of West Kordofan were of relatively acceptable quality. However, some weaknesses around investigations, family planning methods, and supervision were noticed. Therefore, quality research to generate actionable recommendations to address these weaknesses is needed.