| dc.description.abstract | Background This study assesses the competency of
maternal and neonatal health (MNH) professionals at
district-level and subdistrict-level health facilities in
northern Bangladesh in managing maternal and newborn
complications using clinical vignettes. The study also
examines whether the professional’s characteristics and
provision of MNH services in health facilities influence their
competencies.
Methods 134 MNH professionals in 15 government
hospitals were interviewed during August and September
2016 using structured questionnaire with clinical vignettes
on obstetric complications (antepartum haemorrhage
and pre-eclampsia) and neonatal care (low birthweight
and immediate newborn care). Summative scores were
calculated for each vignette and median scores were
compared across different individual-level and health
facility-level attributes to examine their association with
competency score. Kruskal-Wallis test was performed to
identify the significance of association considering a p
value<0.05 as statistically significant.
Results The competency of MNH professionals was low.
About 10% and 24% of the health professionals received
‘high’ scores (>75% of total) in maternal and neonatal
vignettes, respectively. Medical doctors had higher
competency than nurses and midwives (score=11 vs 8
out of 19, respectively; p=0.0002) for maternal vignettes,
but similar competency for neonatal vignettes (score=30.3
vs 30.9 out of 50, respectively). Professionals working in
health facilities with higher use of normal deliveries had
better competency than their counterparts. Professionals
had higher competency in newborn vignettes (significant)
and maternal vignettes (statistically not significant) if they
worked in health facilities that provided more specialised
newborn care services and emergency obstetric care,
respectively, in the last 6 months.
Conclusions Despite the overall low competency of
MNH professionals, exposure to a higher number of
obstetric cases at the workplace was associated with
their competency. Arrangement of periodic skill-based and drill-based in-service training for MNH professionals in
high-use neighbouring health facilities could be a feasible
intervention to improve their knowledge and skill in
obstetric and neonatal care. | en_US |
