Midwife-led continuity of care improved maternal and neonatal health outcomes in north Shoa zone, Amhara regional state, Ethiopia: A quasi-experimental study. Issue 4 (July 2022)

• Record Type: Journal Article
• Authors: Hailemeskel, Solomon; Alemu, Kassahun; Christensson, Kyllike; Tesfahun, Esubalew; Lindgren, Helena
• Is Part Of: Women and birth. Volume 35:Issue 4(2022)
• Page Start: 340
• Page End: 348
• Publication Date: 2022-07
• Subjects: Midwife-led continuity of care -- Shared model of care -- Continuity of care -- Midwifery -- North Shoa -- Ethiopia; Midwives -- Periodicals; Pregnancy -- Periodicals; Midwifery -- Periodicals; Pregnancy -- Periodicals; 618.2
• DOI: 10.1016/j.wombi.2021.08.008
• Languages: English
• ISSNs: 1871-5192

Abstract

Abstract: Background: In 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. Method: A 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. Findings: Women 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)). Conclusion: In 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.