Process evaluation of responsiveness of delivery service in Jimma university medical center, Oromia region, south west, Ethiopia

Abstract

Background: Health system responsiveness is related to the non-monetary, non-clinical quality of care that reflects respect for human dignity and interpersonal aspects of the care process. Obstetric violence and childbirth mistreatment are global problems, but the worst form occurs in low-income countries such as sub-Saharan Africa. Responsiveness is a challenging situation that needs early identification of the specific gaps to tackle. There was paucity or lack of published studies in the topic, disrespect and abuse in maternal care practiced repeatedly in Ethiopia. In JUMC, 91.7% of maternal care service was in disrespect and abusive manner. Objectives: To evaluate responsiveness of labor and delivery service at Jimma university medical center, 2021 Methods: A single-case study design was used for this study, using mixed methods sequentially. In this evaluation, availability with 17 and responsiveness with 24 indcators were used. A quantitative data collection with a sample size of 422 using consecutive method was conducted from May 09– June 02, 2021, and 15 purposefully selected KII for qualitative data. Data entry was done using Epi Data version 4.6.02 and SPSS version 25 for analysis of quantitative data, whereas thematic analysis for qualitative data. Multiple linear regression analysis was used to check the association of the dependent variable with independent variables. Result: A total of 422 respondents participated in this study, with a response rate of 100%. The availability of resources and responsiveness of delivery service in the maternity unit of JUMC was 84.4% and 60.52 %, respectively. Stethoscope, thermometer and guidelines were not available. Some drugs and supplies are frequently interrupted during the evaluation period. One care provider assigned to more than six clients per shift in the maternity unit of JUMC. Care providers’ personal behavior, work overload, and lack of motivation like training hinders them from giving responsive delivery service. At p-value<0.05 at 95%CI, residency, occupation, average monthly income, and mode of current delivery were factors associated with the responsiveness of delivery service. Conclusion and recommendation: The overall responsiveness of delivery service was good in JUMC. Furthermore, to give responsive delivery service, JUMC should recruit more healthcare providers, avail all supplies daily, and better to train healthcare providers