STATUS OF IMPLEMENTATION OF EMERGENCY OBSTETRIC LIFE SAVING SKILLS IN THE HEALTH FACILITIES IN NSUKKA LOCAL GOVERNMENT AREA, ENUGU STATE

Abstract

Emergency Obstetric Live-saving Skills (EmOLSS) are very important skills for doctors, midwives and Community Health Extension Workers (CHEWS). These skills improve their services in maternal and child health. The skills when applied enable the health worker to detect early, prevent and manage obstetric emergencies. This study was therefore designed to determine the status of implementation of EmOLSS among the midwives, and CHEWS working in the primary and secondary health facilities under Nsukka Local Government Area (LGA), Enugu State. This is a descriptive cross-sectional study. Non probability convenience sampling method was used to select 167 midwives/CHEWS from the 14 health facilities under Nsukka L.G.A. The semi-structured questionnaire used for data collection includes: 30-point question on pattern of implementation of EmOLSS and 34 point questions on self-efficacy of the health workers in the implementation of EmOLSS. The health workers` related factors, the client`s social related factors as identified by the health workers and the institutional factors that influence the pattern of implementation of EmOLSS were also included. An observational checklist was used to assess the availability of necessary drugs, materials and equipment in the facilities. Pattern of implementation of EmOLSS score of ≤ 10, 11-20 and 21-30 were rated low, moderate and high respectively. Their selfefficacy in the implementation of EmOLSS scores of ≤ 11, 12-23 and >23 were categorized as low, moderate and high self efficacy. Data were analyzed using descriptive statistics: Chi-square and Fisher`s exact text at P= 0.05. Respondents` mean age score was 39±8.17 years. Midwives personnel were (57) while CHEWS personnel were (109). The respondents` highest qualifications were: RN/RM/RM (18), CHEWS/CHO (129) and BNSC (19). Majority of the respondents (94.4%) were females. About (61.5%) of the respondents had spent ≥11 years in the service while (38.5%) had spent 1-10 years in service. Respondents with poor, fair and good pattern of performance of EmOLSS were (19.8%), (73.1%) and (7.2%) respectively. Respondents with low, moderate and high confidence were (14.4%), (70.7%) and (15.0%). Factors that influence the pattern of performance of EmOLSS includes: Increase work load (65.9%),

forgetfulness of the steps in each EmOLSS (64.7%), inability of the client to understand her role during the implementation of these kills (76.0%), poor knowledge of the outcome of the skills (66.5%), inadequate staff in the labour ward (78.4%), poor electricity supply (80.8%), poor motivation of the health workers (72..5%), irregular payment of salaries of health workers (77.8%) and irregular supportive supervision (91.0%). From the observational checklist, almost half of the facilities (43%) did not have injection magnesium sulphate and (100%) ambulance while majority of the facilities had other essential drugs and equipment. There is significant association between the self-efficacy of the respondent and their pattern of implementation of EmOLSS, The overall status of implementation of EmOLSS was moderate considering their selfefficacy, pattern of implementation of EmOLSS and availability of drugs and equipment.