Midwives’ adherence to guidelines on the management of birth asphyxia in Malawi

Bertha Chikuse, Ellen Chirwa, Alfred Maluwa, Address Malata, Jon Odland

Department of Maternal and Child Health, University of Malawi, Kamuzu College of Nursing, Blantyre, Malawi.
Department of Maternal and Child Health, University of Malawi, Kamuzu College of Nursing, Lilongwe, Malawi.
Faculty of Health Sciences, University of Tromso, Norwegian Agency for Development Cooperation, Tromso, Norway.
Ntcheu District Hospital, Ntcheu, Malawi.
Research Directorate, University of Malawi, Kamuzu College of Nursing, Lilongwe, Malawi.

DOI: 10.4236/ojn.2012.24052                

Abstract

A study was conducted to determine midwives adherence to guidelines on management of birth asphyxia at Queen Elizabeth Central Hospital in Blantyre district, Malawi. The study design was descriptive cross sectional using quantitative data analysis method on 75 midwives that were working in the maternity unit of the hospital. A structured questionnaire was used to collect data on participant’s demographic characteristics and midwives’ comprehension of birth asphyxia and an observational check list was used to observe midwives’ adherence to WHO resuscitation guidelines. In addition midwives were observed on their adherence to the Integrated Maternal and Neonatal Health guidelines that were developed by the Malawi Ministry of Health. The findings indicate that the midwives had knowledge of birth asphyxia in general. However, there were gaps in their ability to identify warning signs of birth asphyxia through partograph use. In addition the midwives did not adhere to 9 out of the 21 steps of the resuscitation guideline. Generally there was substandard adherence to guidelines on identification of warning signs of birth asphyxia and neonatal resuscitation. On the other hand, the facility did not have adequate resuscitation equipment and supplies. The results are discussed in relation to the importance of adhering to resuscitation guidelines in the management of birth asphyxia for babies that do not breathe at birth. Training of the midwives on partograph use and resuscitation to improve neonatal outcomes is recommended. It is recommended further that the health facility should have adequate resuscitation equipment and supplies.

Keywords

Birth Asphyxia; Resuscitation Guidelines; Neonates; Use of Partograph; Virginia Apgar Scoring

Conflicts of Interest

The authors declare no conflicts of interest.

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