Evaluation of maternal and newborn health services in Jordan

Abstract

Objectives

This study aimed to assess the maternal and newborn services in Jordanian hospitals to provide policymakers, health professionals, and researchers with a clear picture about the current status of maternal and newborn health services.

Methods

A total of 32 main hospitals that provide maternity services in Jordan were assessed. The study involved direct observations of these hospitals and interviews with basic health and hospital staff, with the purpose of assessing and evaluating the availability of various services for mothers and newborns, availability of resources, equipment and supplies, documentation and staff training, and provision of the health care services.

Results

Some hospitals had shortages of obstetricians and gynecologists, pediatricians, neonatologists, and midwives/nurses. Antenatal care was not provided systematically in many hospitals across the country. A lack of necessary equipment, drugs, and supplies was evident in some hospitals. Admission departments of some hospitals had insufficient supplies. The operation theaters in many hospitals lacked a variety of necessary equipment including some basic items such as thermometers and some advanced items such as resuscitation sets for babies. Only two-thirds of all delivery rooms in the selected hospitals had radiant heaters and obstetrical stethoscopes available. A significant lack of neonatal ICU equipment was found such as incubators, resuscitation tables, continuous positive airway pressure, O2 oximeters, and phototherapy.

Conclusion

The findings revealed an overall satisfactory quality of maternal and newborn care and services, however, some deficiencies existed. The findings are expected to aid policymakers, health professionals, and researchers to recognize the gaps in the processes, supplies, and quality of care related to the provided services at maternal facilities and help them to design and implement evidence-based health programs in order to provide effective health services and promote the health of mothers and newborns.

Keywords:

• maternal and newborn health services
• assessment
• quality of care
• Jordan

Supplementary materials

Supplementary material S1 Maternal and Newborn Services Rapid Facility Assessment Forms

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A. Service availability

[Please interview both the head of the maternity and the head of neonatal unit and ask about the availability of the following services]

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B. Human resources

B.1 Is a person (specialist/resident) skilled in conducting deliveries present at the facility or on call at all times (24 hours a day), including weekends, to provide delivery care?

1. Yes, present

2. Yes, on call

3. No 24-hour coverage

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C. Basic and comprehensive emergency obstetric care and neonatal care

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D. Antenatal care

[Ask the head of the maternity]

D1. Does this facility provide antenatal care?

1. Yes [if yes fill in the table below]

2. No [If no go to section E]

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E. Admission department (maternity)

Please observe and indicate if the following are available in the admission department:

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F. Delivery room

F.1 Number of delivery rooms in the facility []

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G. Delivery block/department

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H. Operation theater (OT)

H1. Number of operation theaters []

H2. Check in each operation theater

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I. NICU

What is the maximum capacity of infants in the NICU? [___]

What is the total number of nurses working in NICU? [___]

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J. Other equipment, drugs and supplies in the facility overall

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K. Practices

Based on the interview with available health care providers, which of the following are implemented according to WHO recommendations?

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Does the facility have a separate space (apart from the delivery room) for mothers and newborns together or for newborns only (postnatal area/ward)?

1. Yes, mothers and newborns together

2. Yes, for newborns only

3. No

Does this facility practice Kangaroo Mother Care for low birth-weight babies?

1. Yes, for all

2. Yes, for some

3. No, at all

L. Documentation, guidelines, policies, and statistics

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M. Trained staff

Please ask the following questions to all available providers of delivery and newborn services

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Acknowledgments

The authors would like to acknowledge Koninklijk Instituut voor de Tropen (Share-Net International) for their financial and technical support.

Disclosure

The authors report no conflicts of interest in this work.