Obstetric Care and Health System Responsiveness for Hospital-Based Delivery in Lao People’s Democratic Republic

Daovieng Douangvichit MD*, Tippawan Liabsuetrakul MD, PhD**

Affiliation : * National Institute of Public Health, Ministry of Health, Lao PDR ** Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand

Objective : To assess obstetric care and health system responsiveness for hospital-based delivery care in Lao PDR, and associated factors. Material and Method: A cross-sectional study was conducted in two provincial hospitals in Lao PDR between June and October 2010. All delivered women were interviewed for their perception of health system responsiveness and their medical records were reviewed for the obstetric care they received.
Results : Five hundred eighty one women participated in this study. The mean scores of obstetric care and health system responsiveness were 19.5  2.5 and 31.6  1.5, respectively. The mean score of overall performance was 51.0  2.8. Of the two hospitals, designated as Hospital A and Hospital B, the health responsiveness was rated lower in women undergoing cesarean section and delivering in Hospital B. Male doctor or obstetrician or delivery in Hospital B was significantly associated with higher obstetric care and overall performance.
Conclusion : Different health system responsiveness for the delivery care between the two hospitals was found. Strategies to improve obstetric care need to be discussed and studied.

Keywords : Health system responsiveness, Hospital-based delivery care, Obstetric care, Essential skills, Skilled birth attendant

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