Examination of the Adoption and Implementation of International Labor Room Standards in Public Hospitals: A Case Study of Dir Lower, Khyber Pakhtunkhwa, Pakistan
Keywords:
Adoption, Implementation, Maternal, Neonatal, QSR Nudist and InternationalAbstract
This research study investigates into the adoption and implementation of international labor room standards in public hospitals, focusing on Dir Lower, Khyber Pakhtunkhwa, Pakistan. These standards, established by the World Health Organization (WHO), aim to bolster the safety of both mothers and infants during childbirth by encircling essential elements like continuous fetal monitoring, infection control, diverse pain management options, obstetric emergency readiness, and patient-centered care. The study aims to uncover challenges and successes, ultimately contributing to safer childbirth experiences and improved neonatal care in the region. This study combines qualitative data by conducting interviews with healthcare provider’s mothers who have experienced childbirth in public hospitals to assess the adoption and implementation of these standards. Purposive sampling technique was employed, resulting in a sample of 12 mothers as potential respondents. Data analysis was carried out using thematic analysis procedures with the assistance of qualitative data management software, QSR Nudist. This study uncovered several key findings regarding the adoption and implementation of international labor room standards in public hospitals in Dir Lower, Khyber Pakhtunkhwa, Pakistan. Healthcare providers displayed a solid grasp of these standards, emphasizing their role in ensuring maternal and infant safety. However, challenges in implementation, such as resource limitations and adherence issues, were evident, particularly concerning medical equipment availability and staff training for obstetric emergencies. Healthcare provider’s mothers recognized the importance of patient-centered care, though communication improvements were noted. Public hospitals offered diverse pain management options, well-received by mothers, and continuous fetal monitoring was deemed crucial for early issue detection.
References
Abdullah, T., Khan, M. I., Shah, S. M. U., & Ullah, S. (2023). Intrinsic and Extrinsic Factors Affecting Job Satisfaction: A Comparative Study of Public and Private Primary School Teachers. Journal of Education and Social Studies, 4(2), 348-358.
Agyenim-Boateng, A., Cameron, H., & Mensah, A. B. B. (2021). Health professionals’ perception of disrespectful and abusive intrapartum care during facility-based childbirth in LMIC: a qualitative systematic review and thematic synthesis. International Journal of Africa Nursing Sciences, 15, 100326.
Akrich, M., Leane, M., Roberts, C., & Arriscado Nunes, J. (2014). Practising childbirth activism: A politics of evidence. BioSocieties, 9, 129-152.
Ali, S. (2008). Conservation and status of markhor (capra falconeri) in the northen parts of north west frontier province, Pakistan.
Batool, A., Razaq, S., Javaid, M., Fatima, B., & Toyama, K. (2017, November). Maternal complications: Nuances in mobile interventions for maternal health in urban Pakistan. In Proceedings of the Ninth International Conference on Information and Communication Technologies and Development (pp. 1-12).
Bhutta, Z. A., Hafeez, A., Rizvi, A., Ali, N., Khan, A., Ahmad, F., ... & Jafarey, S. N. (2013). Reproductive, maternal, newborn, and child health in Pakistan: challenges and opportunities. The Lancet, 381(9884), 2207-2218.
Bonapace, J., Gagné, G. P., Chaillet, N., Gagnon, R., Hébert, E., & Buckley, S. (2018). No. 355 physiologic basis of pain in labour and delivery: an evidence-based approach to its management. Journal of obstetrics and gynaecology Canada, 40(2), 227-245.
Crowther, S. A., Hall, J., Balabanoff, D., Baranowska, B., Kay, L., Menage, D., & Fry, J. (2021). Spirituality and childbirth: An international virtual co–operative inquiry. Women and Birth, 34(2), e135-e145.
Dar, S., & Afzal, U. (2015). Education and maternal health in Pakistan: the pathways of influence. The Lahore Journal of Economics, 20(2), 1.
De Beauvoir, S. (1997). Introduction to the second sex. na.
Downe, S. (Ed.). (2008). Normal childbirth: Evidence and debate. Elsevier Health Sciences.
Duysburgh, E., Zhang, W. H., Ye, M., Williams, A., Massawe, S., Sié, A., ... & Temmerman, M. (2013). Quality of antenatal and childbirth care in selected rural health facilities in Burkina Faso, Ghana and Tanzania: similar finding. Tropical medicine & international health, 18(5), 534-547
Farrukh, M. J., Tariq, M. H., & Shah, K. U. (2017). Maternal and perinatal health challenges in Pakistan. J. Pharm. Pract. Community Med, 3, 76-77.
Felstiner, M. L. (1980). Seeing" The Second Sex" through the Second Wave. Feminist Studies, 6(2), 247.
Hafeez, A., Mohamud, B. K., Shiekh, M. R., Shah, S. A. I., & Jooma, R. (2011). Lady health workers programme in Pakistan: challenges, achievements and the way forward. JPMA. The Journal of the Pakistan Medical Association, 61(3), 210.
Iqbal, S., Maqsood, S., Zakar, R., Zakar, M. Z., & Fischer, F. (2017). Continuum of care in maternal, newborn and child health in Pakistan: analysis of trends and determinants from 2006 to 2012. BMC health services research, 17(1), 1-15.
Khan, H. A., Ahmad, A., & Mehboob, R. (2015). Nosocomial infections and their control strategies. Asian pacific journal of tropical biomedicine, 5(7), 509-514.
Khan, Y. P., Bhutta, S. Z., Munim, S., & Bhutta, Z. A. (2009). Maternal health and survival in Pakistan: issues and options. Journal of obstetrics and gynaecology canada, 31(10), 920- 929.
Khan, Y. P., Bhutta, S. Z., Munim, S., & Bhutta, Z. A. (2009). Maternal health and survival in Pakistan: issues and options. Journal of obstetrics and gynaecology canada, 31(10), 920- 929.
Khosla, R., Zampas, C., Vogel, J. P., Bohren, M. A., Roseman, M., & Erdman, J. N. (2016). International human rights and the mistreatment of women during childbirth. Health and human rights, 18(2), 131.
Lothian, J. A. (2007). The Lamaze certified childbirth educator: standards of practice. The Journal of Perinatal Education, 16(1), 29.
Maheen, H., Hoban, E., & Bennett, C. (2021). Factors affecting rural women's utilisation of continuum of care services in remote or isolated villages or Pakistan–A mixed-methods study. Women and Birth, 34(3), 257-265.
Malik, M. A., Rohm, L. R., van Baal, P., & van Doorslaer, E. V. D. (2021). Improving maternal and child health in Pakistan: a programme evaluation using a difference in difference analysis. BMJ global health, 6(12), e006453.
Malik, M. F., & Kayani, M. A. (2014). Issues of maternal health in Pakistan: trends towards millennium development goal 5. JPMA. The Journal of the Pakistan Medical Association, 64(6), 690-693.
Moshi, F. V., & Mbotwa, C. H. (2020). Determinants for choice of home birth over health facility birth among women of reproductive age in Tanzania: an analysis of data from the 2015-16
Mumtaz, Z., Salway, S., Bhatti, A., Shanner, L., Zaman, S., Laing, L., & Ellison, G. T. (2014). Improving maternal health in Pakistan: toward a deeper understanding of the social determinants of poor women’s access to maternal health services. American journal of public health, 104(S1), S17-S24.
Mustafa, M., Batool, A., Fatima, B., Nawaz, F., Toyama, K., & Raza, A. A. (2020, April). Patriarchy, maternal health and spiritual healing: Designing maternal health interventions in Pakistan. In Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems (pp. 1-13).
Nasrullah, M., Zakar, R., & Krämer, A. (2013). Effect of child marriage on use of maternal health care services in Pakistan. Obstetrics & Gynecology, 122(3), 517-524.
Oladapo, O. T., Bohren, M. A., Fawole, B., Mugerwa, K., Ojelade, O. A., Titiloye, M. A., ... & Gülmezoglu, A. M. (2017). Negotiating quality standards for effective delivery of labor and childbirth care in Nigeria and Uganda. International Journal of Gynecology & Obstetrics, 139, 47-55.
Omer, S. (2019). The social and cultural factors of maternal mortality in the context of three delays: the perspective of lady health workers of South Punjab, Pakistan. Pakistan Vision, 20(1),
Omer, S., Zakar, R., Zakar, M. Z., & Fischer, F. (2021). The influence of social and cultural practices on maternal mortality: a qualitative study from South Punjab, Pakistan. Reproductive health, 18(1), 1-12.
Pumpure, E., Jakovicka, D., Mariani, I., Vaska, A., Covi, B., Valente, E. P., ... & Mueller, A. (2022). Womenʼs perspectives on the quality of maternal and newborn care in childbirth during the COVID‐19 pandemic in Latvia: Results from the IMAgiNE EURO study on 40 WHO standards‐based quality measures. International Journal of Gynecology & Obstetrics, 159, 97-112.
Riley, I. D., Hazard, R. H., Joshi, R., Chowdhury, H. R., & Lopez, A. D. (2019). Monitoring progress in reducing maternal mortality using verbal autopsy methods in vital registration systems: what can we conclude about specific causes of maternal death? BMC medicine, 17, 1-4.
Sahin, B. M., & Kabakci, E. N. (2021). The experiences of pregnant women during the COVID-19 pandemic in Turkey: A qualitative study. Women and Birth, 34(2), 162-169.
Sarfraz, M., Tariq, S., Hamid, S., & Iqbal, N. (2016). Social and societal barriers in utilization of maternal health care services in rural Punjab, Pakistan. Journal of Ayub Medical College Abbottabad, 27(4), 843-849.
Sattar, T., Usman, A., & Saleem, U. (2019). Socio-reproductive and demographic factors affecting the decision making of ever married fertile females towards want of another child in future: a study of state based hospitals in Multan. Pakistan Isra Med J, 11(4), 252-256.
Simons, M. A. (1983, January). The silencing of Simone de Beauvoir guess what's missing from the second sex. In Women's Studies International Forum (Vol. 6, No. 5, pp. 559-564). Pergamon.
Strauss, A., & Corbin, J. (1998). Basics of qualitative research techniques.
Villar, J., Ismail, L. C., Victora, C. G., Ohuma, E. O., Bertino, E., Altman, D. G., ... & Kennedy, S. H. (2014). International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. The Lancet, 384(9946), 857-868.
Vogel, J. P., Bohren, M. A., Tunçalp, Ӧ., Oladapo, O. T., & Gülmezoglu, A. (2016). Promoting respect and preventing mistreatment during childbirth. Bjog, 123(5), 671.
World Health Organization. (2018). Definition of skilled health personnel providing care during childbirth: the 2018 joint statement by WHO, UNFPA, UNICEF, ICM, ICN, FIGO and IPA (No. WHO/RHR/18.14). World Health Organization
Yakovi Gan-Or, N. (2020). Going solo: the law and ethics of childbirth during the COVID-19 pandemic. Journal of Law and the Biosciences, 7(1), lsa.
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