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. 2023 May 9;23(1):331.
doi: 10.1186/s12884-023-05678-3.

Quality of maternal and newborn health care at private hospitals in Iraq: a cross-sectional study

Hannah Tappis #  1 , Rebaz Lak #  2 , Riyadh Alhilfi  3 , Aso Hameed Zangana  4 , Falah Wadi  5 , David Hipgrave  6 , Shaimaa Ibrahim  7
Affiliations

Quality of maternal and newborn health care at private hospitals in Iraq: a cross-sectional study

Hannah Tappis et al. BMC Pregnancy Childbirth. .

Abstract

Background: Approximately 25% of facility births take place in private health facilities. Recent national studies of maternal and newborn health (MNH) service availability and quality have focused solely on the status of public sector facilities, leaving a striking gap in information on the quality of maternal and newborn care services.

Methods: A rapid cross-sectional assessment was conducted in November 2022 to assess the quality of MNH services at private hospitals in Iraq. Multi-stage sampling was used to select 15% of the country's 164 private hospitals. Assessment tools included a facility assessment checklist, a structured health worker interview tool, and a structured client exit interview tool. Data collection was conducted using KoboToolbox software on Android tablets, and analysis conducted using SPSS v28.

Results: All hospitals visited provided MNH services and had skilled personnel present or on-call 24 h/day, 7 days/week. Most births (88%) documented between January and June 2022 were cesarean births. Findings indicate that nearly all hospitals have the human resources, equipment, medicines and supplies necessary for quality antenatal, intrapartum and early essential newborn care, and many are also equipped with special units and resources needed to care for small and sick babies. However, while resources are in place for basic and advanced care, there are gaps in knowledge and practice of high-impact interventions that require few or no resources to perform, including skin-to-skin thermal care and support for early initiation of breastfeeding. Person-centered maternity care scores suggest that private hospitals offer a positive experience of care for all clients, however there is room for improvement in provider-client communication.

Conclusions: This assessment highlights the need for deeper dives into factors that underly decisions about how and where to give birth, and both understanding and practice of early essential newborn care and pre-discharge examinations and counseling at private healthcare facilities in Iraq. Engaging private health facility staff in efforts to monitor and improve the quality of maternal and newborn care, with a focus on early essential newborn care and provider-client communication for all clients, will ensure that women and newborns benefit from the best care possible with available resources.

Keywords: Cesarean birth; Iraq; Maternal health; Newborn health; Private sector; Quality of care.

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Conflict of interest statement

Hannah Tappis (HT) is an Associate Editor of BMC Pregnancy and Childbirth but had no role in the handling of this manuscript. Rebaz Lak (RL), Riyadh Alhilfi (RA), Aso Hameed Zangana (AHZ), Falah Wadi (FW), David Hipgrave (DH), and Shaimaa Ibrahim (SI) declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Percent of hospitals with data available on maternal and newborn health services, and type of record available
See this image and copyright information in PMC

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