Midwife-led continuity of care improved maternal and neonatal health outcomes in north Shoa zone,Amhara regional state,Ethiopia: A quasi-experimental study |
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| Institution: | 1. School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia;2. Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia;3. Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institute, Sweden;4. Department of Public Health, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia;5. Department of Midwifery, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia;1. School of Nursing and Midwifery, Parramatta South Campus, Western Sydney University, NSW, Australia;2. Graduate Research School and the Centre for Research in Mathematics and Data Science, Western Sydney University, NSW, Australia;1. Clinical and Health Sciences, University of South Australia, Australia;2. College of Nursing and Health Sciences, Flinders University, Australia;3. School of Nursing and Midwifery, Deakin University and Western Health Partnership, Australia;1. Uppsala University, Department of Women’s and Children’s Health, Akademiska University Hospital, SE-751 85 Uppsala, Sweden;2. Sophiahemmet University, Department of Health Promoting Science, SE-114 86 Stockholm, Sweden;1. Centenary Hospital for Women and Children, and University of Canberra, Faculty of Health, 11 Kirinari St, Bruce, ACT 2617, Australia;2. ACT Government Health Directorate and University of Canberra, Faculty of Health, 11 Kirinari St, Bruce, ACT 2617, Australia |
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| Abstract: | BackgroundIn a low-resource setting, information on the effect of midwife-led continuity of care (MLCC) is limited. Therefore, this study aimed to determine the effect of MLCC on maternal and neonatal health outcomes in the Ethiopian context.MethodA study with a quasi-experimental design was conducted from August 2019 to September 2020 in four primary hospitals of the north Shoa zone, Amhara regional state, Ethiopia. A total of 1178 low risk women were allocated to one of two groups; the midwife-led continuity of care (MLCC or intervention group) (received all antenatal, labour, birth, and immediate postnatal care from a single midwife or backup midwife) (n = 589) and the Shared model of care (SMC or comparison group) (received care from different staff members at different times) (n = 589). The two outcomes studied were Spontaneous vaginal birth and preterm birth. Outcome variables were compared using multivariate generalized linear models (GLMs) and reported using adjusted risk ratios (aRR) with 95% confidence intervals.FindingsWomen in MLCC were, in comparison with women in the SMC group more likely to have spontaneous vaginal birth (aRR of 1.198 (95% CI 1.101–1.303)). Neonates of women in MLCC were in comparison with those in SMC less likely to be preterm (aRR of 0.394; 95% CI (0.227–0.683)).ConclusionIn this study, use of the MLCC model improved maternal and neonatal health outcomes. To scale up and further investigate the effect and feasibility of this model in a low resource setting could be of considerable importance in Ethiopia and other Sub-Saharan Africa countries. |
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| Keywords: | Midwife-led continuity of care Shared model of care Continuity of care Midwifery North Shoa Ethiopia |
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