Providers’ Perceptions of Service Utilisation and Quality of Emergency Obstetrics and Newborn Care (EmONC) Service among Public Facilities Operating in the Ayeyerwaddy Region, Myanmar

Abstract

Background: High maternal, neonatal and under-five children deaths have been a chronic problem in Myanmar despite several interventions are implemented by ministry and its partners. This has indicated the existence of unsolved issues around EmONC but there are very limited studies on EmONC in Myanmar. Therefore, this study findings would provide valuable information for policy maker and key MNCH partners to consider in planning of effective EmONC strategy.

Aims: The primary aim is to explore the providers’ perceptions of quality of EmONC available at their facilities and their views related to issues around EmONC utilisation by pregnant mothers.

Methodology: This study applied the cross-sectional qualitative design using Individual Indepth interview (IDI) method as it permitted in-depth investigation of providers’ perceptions related to EmONC. A total of 16 IDI sessions were administered to the providers who are working at different level of facilities in Ayeyarwaddy region of Myanmar.

Results: Participants perceived the quality of current EmONC as above average while indicating that their EmONC learning in pre-service and early career days were insufficient. Inadequate human resources and workload, insufficient providers’ competency and poor attitude, inadequate equipment and supplies, and inadequate infrastructure including nonfunctioning ransportation were identified as health system related challenges while lack of health awareness was identified as community related challenge in EmONC provision. And low level of community health awareness, socioeconomic status related barriers, inappropriate providers’ communication and behavior are main barriers for pregnant mothers in EmONC utilisation as reported by participants. In addition, suggestions for health system related challenges such as to ensure adequate health manpower, to improve providers’ EmONC competency and communication, to ensure sufficient resources and adequate infrastructures and suggestions for community related challenges such as to focus on improving community health awareness and to engage with community members in EmONC provision were also made by study participants.

Conclusion: Though participant viewed quality of EmONC as above average, the study findings show a clear existence of three delays that impacted on quality and utilisation of EmONC. This indicated that large scale investigation of challenges that cause these three delays in different geographical settings should be conducted to gather information for developing the effective EmONC strategy of which implementation should be properly made n close collaboration with key MNCH implementation partners.

Key Words: EmONC, Quality, Perceptions, Challenges, Utilisation, Myanmar