Browsing by Author "Namwaya, Ziidah"

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    Midwives’ practice and perception of labour and delivery care at the Mulago National Referral Hospital, Uganda
    (African Journal of Midwifery and Women's Health, 2020) Namwaya, Ziidah; Kaye, Dan; Nalwadda, Gorrette; Edwards, Grace; Nabirye, Rose C.
    Background/Aims The majority of maternal deaths occur during labour, delivery, or within the first 4 hours after birth. This can be reduced by the care that midwives provide. At Mulago Hospital, little is documented on midwives’ current practice and their perception of care offered during labor and delivery. The number of maternal and neonatal deaths as a result of preventable causes such as postpartum haemorrhage, obstructed labour, ruptured uterus and sepsis remains high. The aim of this study was to document the current practice of midwives, explore midwives’ perception towards practice and identify factors that influence practice during birth in Uganda, to identify possible areas for improvement. Methods A cross-sectional study was conducted of midwives working in the three labour wards at the Mulago National referral hospital: the general ward, the private ward and the midwifery-led ward. Midwives’ perceptions were explored using a semi-structured questionnaire, which asked midwives about their current practice and their perception of the care offered. Findings Care was found to be lacking in several areas. Only one-fifth (20.0%) of midwives reported always checking temperature every 4 hours. Only 20.5% reported that women are always supported in being mobile during labour. Less than half of the midwives (44.4%) knew the recommended drugs for managing the third stage of labour. Infection prevention practices were poor. Only 54% of midwives knew how to prepare magnesium sulphate for management of severe pre-eclampsia and eclampsia. Overall, the general labour ward was found to have the most gaps in midwives’ knowledge. Lack of continuing education, supplies, teamwork and clinical guidelines were reported to affect practice. Staff shortages and midwives’ decisions being underlooked by obstetricians were also reported to affect practice.
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    Midwives’ practice and perception of labour and delivery care at the Mulago National Referral Hospital, Uganda
    (African Journal of Midwifery and Women's Health, 2020-04-16) Namwaya, Ziidah; Namagembe, Imelda; Kaye, Dan; Nalwadda, Gorrette; Edwards, Grace; Nabirye, Rose Chalo
    The majority of maternal deaths occur during labour, delivery, or within the first 4 hours after birth. This can be reduced by the care that midwives provide. At Mulago Hospital, little is documented on midwives' current practice and their perception of care offered during labor and delivery. The number of maternal and neonatal deaths as a result of preventable causes such as postpartum haemorrhage, obstructed labour, ruptured uterus and sepsis remains high. The aim of this study was to document the current practice of midwives, explore midwives' perception towards practice and identify factors that influence practice during birth in Uganda, to identify possible areas for improvement. A cross-sectional study was conducted of midwives working in the three labour wards at the Mulago National referral hospital: the general ward, the private ward and the midwifery-led ward. Midwives' perceptions were explored using a semi-structured questionnaire, which asked midwives about their current practice and their perception of the care offered. Care was found to be lacking in several areas. Only one-fifth (20.0%) of midwives reported always checking temperature every 4 hours. Only 20.5% reported that women are always supported in being mobile during labour. Less than half of the midwives (44.4%) knew the recommended drugs for managing the third stage of labour. Infection prevention practices were poor. Only 54% of midwives knew how to prepare magnesium sulphate for management of severe pre-eclampsia and eclampsia. Overall, the general labour ward was found to have the most gaps in midwives' knowledge. Lack of continuing education, supplies, teamwork and clinical guidelines were reported to affect practice. Staff shortages and midwives' decisions being underlooked by obstetricians were also reported to affect practice. Overall, the study found that midwifery practice is suboptimal in key areas such as infection prevention, use of a partograph, and management of pre-eclampsia and eclampsia. Continuous professional development, provision of resources, and strengthening teamwork are recommended to improve maternal health outcomes at Mulago Hospital.
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    Partograph initiation and completion: a criteria-based audit study in Uganda
    (African Journal of Midwifery and Women's Health, 2017-06-18) Namwaya, Ziidah; Ayebare, Elizabeth; Muwanguzi, Sarah; Namutebi, Mariam; Birungi,Susan; Namutebi, Elizabeth; Mwebaza, Enid; Smyth, Rebecca
    Although it is a cost effective tool in labour management, the partograph is not always used appropriately. The aim of this audit was to assess the initiation and completion of the partograph for women in labour at Mulago Hospital. A criteria-based audit was conducted, using patients’ files and delivery records from February to May 2016. A checklist was used to gather data and descriptive statistics computed. Of 7170 files, 256 (3.57%) had the partograph initiated. The recording of maternal wellbeing was low. For example, pulse was recorded in 20% of cases and blood pressure in 35%. Recording of vaginal examination results was 90% on admission but reduced to 57% in the first stage of labour. Similarly, recording of fetal heart rate in the first stage of labour was 62%. Partograph initiation was unacceptably low. Maternal well-being documentation was generally low compared to the set standard. There is need to strengthen the use of a partograph to improve care during labour