Kokusai Hoken Iryo (Journal of International Health)
Print ISSN : 0917-6543
Volume 26 , Issue 2
Showing 1-9 articles out of 9 articles from the selected issue
Special articles of the Workshop in The 25th Annual Meeting of the Japan Association for International Health
  • Wakako FUJITA, Kazutomo OHASHI, Naoki NAKAZONO
    2011 Volume 26 Issue 2 Pages 119-129
    Published: June 20, 2011
    Released: August 04, 2011
    Millennium development goal 5 (MDG 5) is to reduce the maternal mortality rate by 75%. Due to the shortage of medical doctors in sub-Saharan African countries, midwives have been compelled to take an important responsibility for the outcome of delivery. Therefore, to achieve MDG 5, strengthening midwives’ /professional ability is essential. However, less attention has been paid to the quality of midwifery care.
    This study investigated the process of delivery care provided by midwives in the labor room at a public hospital in Tanzania and assessed the quality of midwifery care.
    1.Data collection from delivery records
    2.Observation of delivery care at the point of delivery in the labor ward.
    I conducted an observational study in the delivery room of Mwananyamala Hospital in Dar es Salaam, the capital of Tanzania, for a total of 43 hours over 7 days.
    3.Semi-structured interviews were conducted with 10 midwives at the hospital.
    In our evaluation and analysis, the classification of practices during normal birth published by WHO were used as a benchmark.
    There were 257 deliveries during the 7days of observation. Still birth occurred in 15 cases. The average maternal age was 23.8 years old and 55.5% were primiparas. Since only 3 midwives working in three shifts conducted all deliveries, the shortage of staff was obvious.We noted three issues of midwifery care as follows:
    1.Delivery care was not mother-centered.
    2.Continuous and careful monitoring of labor was not performed.
    3.Medical treatment and drugs were administrated inappropriately and may cause rupture of the uterus and hemorrhage.
    To achieve the goal of MDG5, it is necessary not only to focus on the outcome indicator but also to improve the quality of midwifery care.
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