Service providers' perception of the quality of emergency obsteric care provided and factors indentified which affect the provision of quality care.

AIM The aim of the study was to investigate health workers' perception of the quality of, and factors which impact provision of quality emergency obstetric care. METHODS This exploratory, descriptive qualitative study was conducted at Mwanza district hospital in Malawi. Qualitative data was obtained through 14 individual in-depth interviews with the health workers involved in the management of women who experienced major obstetric complications. RESULTS The health workers' overall perception of the quality of emergency obstetric care provided was poor. The poor quality of care was identified as related to client related factors and facility/staff factors. Client factors which emerged as contributing to poor quality care were; the client delay in seeking care: reliance on TBAs, reliance on traditional medications, and lack of awareness regarding signs of an obstetric emergency. Facility/ staff themes which emerged as contributing to the poor care were; inadequate resources, inadequate staffing, poor teamwork, and inadequate knowledge/supervision. CONCLUSION The findings of this study reveal that health care workers rate the quality of emergency obstetric care they provide as poor. They were able to identify structure and process factors which contribute to this overall poor quality emergency obstetric care provided. These were attributed to health care system problems and client problems. Only through addressing the contributing factors will true improvement of management of obstetric emergencies occur.