Suchergebnisse

Background: Electronic-health (e-health) provides opportunities for quality improvement of healthcare, but implementation in low and middle income countries is still limited. Our aim was to describe the implementation of a registration (case record form; CRF) for obstetric interventions and childbirth events using e-health in a prospective birth cohort study in Palestine. We also report the completeness and the reliability of the data. Methods: Data on maternal and fetal health was collected prospectively for all women admitted to give birth during the period from 1st March 2015 to 31st December 2015 in three governmental hospitals in Gaza and three in the West Bank. Essential indicators were noted in a case registration form (CRF) and subsequently entered into the District Health Information Software 2 (DHIS 2) system. Completeness of registered cases was checked against the monthly hospital birth registries. Reliability (correct information) of DHIS2 registration and entry were checked for 22 selected variables, collected during the first 10 months. In the West Bank, a comparison between our data registration and entry and data obtained from the Ministry of Health patient electronic records was conducted in the three hospitals. Results: According to the hospital birth registries, a total of 34,482 births occurred in the six hospitals during the study period. Data on the mothers and children registered on CRF was almost complete in two hospitals (100% and 99.9%); in the other hospitals the completeness ranged from 72.1% to 98.7%. Eighty birth events were audited for 22 variables in the three hospitals in the West Bank. Out of 1760 registrations in each hospital, the rates of correct data registration ranged from 81% to 93.2% and data entry ranged from 84.5% to 93.1%. Conclusions: The registered and entered data on birth events in six hospitals was almost complete in five out of six hospitals. The collected data is considered reliable for research purposes.

Background Electronic-health (e-health) provides opportunities for quality improvement of healthcare, but implementation in low and middle income countries is still limited. Our aim was to describe the implementation of a registration (case record form; CRF) for obstetric interventions and childbirth events using e-health in a prospective birth cohort study in Palestine. We also report the completeness and the reliability of the data. Methods Data on maternal and fetal health was collected prospectively for all women admitted to give birth during the period from 1st March 2015 to 31st December 2015 in three governmental hospitals in Gaza and three in the West Bank. Essential indicators were noted in a case registration form (CRF) and subsequently entered into the District Health Information Software 2 (DHIS 2) system. Completeness of registered cases was checked against the monthly hospital birth registries. Reliability (correct information) of DHIS2 registration and entry were checked for 22 selected variables, collected during the first 10 months. In the West Bank, a comparison between our data registration and entry and data obtained from the Ministry of Health patient electronic records was conducted in the three hospitals. Results According to the hospital birth registries, a total of 34,482 births occurred in the six hospitals during the study period. Data on the mothers and children registered on CRF was almost complete in two hospitals (100% and 99.9%); in the other hospitals the completeness ranged from 72.1% to 98.7%. Eighty birth events were audited for 22 variables in the three hospitals in the West Bank. Out of 1760 registrations in each hospital, the rates of correct data registration ranged from 81% to 93.2% and data entry ranged from 84.5% to 93.1%. Conclusions The registered and entered data on birth events in six hospitals was almost complete in five out of six hospitals. The collected data is considered reliable for research purposes.

Objective To explore the rates, characteristics and indications for episiotomy among women delivering vaginally for the first time, as well as parous women. Study design A prospective, population-based birth cohort study. Setting Obstetric departments in six Palestinian government hospitals. Participants All women with singleton vaginal births (n=29 165) from 1 March 2015 until 1 March 2016. Methods All women were divided into two groups: first vaginal birth group (n=9108), including primiparous women and women with their first vaginal birth after one caesarean section, and the parous group (n=20 057). Each group was analysed separately. Data were presented as numbers and percentages or range. Differences in rates were assessed by the p values of χ2 test, or Fisher's exact test if there are cell counts less than 5. Main outcome measures Episiotomy rates and indications among women of singleton births. Results The overall episiotomy rate was 28.7%: 78.8% for women with first vaginal birth (range 56.6%–86.0%) and 5.9% for parous women (range 1.0% 9.5%). The most common indications for episiotomy were 'primiparity' in the first vaginal birth group (69.9%) and 'protecting the perineum' in the parous group (59.5%). The least common indications were prolonged second stage (1.5%) and fetal distress (6.9%), respectively. Conclusion In Palestine, the majority of women who delivered vaginally for the first time had an episiotomy. Education of birth attendants, clinical audits, educational interventions and adherence to the updated guidelines may help to decrease the routine overuse of episiotomy ; Norwegian Research Council