Abstract:
The input variable for maternity services were assessed in terms of availability of human
resources, infra-structure and equipment, supportive services, and monitoring and
evaluation. The performance of maternity units was determined by outcome of admissions,
delivery practices, status of the mother and the newborn and patient satisfaction. Data was
collected using specially designed checklists, questionnaires and data sheets. Principal
investigator and trained data collectors gathered data by visiting institutions and field during
the study period. Premature Baby Units and Intensive Care facilities were available in all
maternity units, however, inadequacy of trained personnel was observed in all. The
accessibility to these specialized units was unsatisfactory in many institutions mainly due to
poor planning and unavailability of master plans for institutions. The hospitals were
categorized into two groups i.e. group with better management (A) and the group with poor
management (B) based on the rank obtained using two criteria, availability of resources and
management of available resources. The overall assessment showed that group A hospitals
which had better management practices led to favorable maternal outcomes, better quality of
services and higher patient satisfaction compared to Group B. The findings highlighted that
good management with adequate resources; capacity building of staff, regular monitoring
and supervision resulted in improved performance of the maternity units reviewed in this
study. The correlation test applied to determine the relationship between independent and
outcome variables also showed that hospitals with improved performance had a positive
correlation with monitoring supervision, training and skill development as opposed to the
availability of human resources and infrastructure facilities
