Using signal functions to measure third delays in the management of obstetric emergencies: a study of Midigo Health Centre IV

Abstract

Background: Signal functions are a representative shortlist of key interventions and activities that address major causes of morbidity or mortality and that are indicative of a certain type and level of care in a health facility. For example, signal functions indicative of "basic emergency obstetric care (EmOC)" could be provided by midwives at a lower level health centre, whereas "comprehensive EmOC" signal functions indicate a higher level of care, usually at a hospital or . Thus, signal function test is very vital in measuring Obstetric and Newborn Functionality of Health Facilities. On the other hand, third delays are the delays in receiving adequate and appropriate treatment at the healthcare facility by mothers during and after pregnancy. Purpose: The aim of the study was to determine the quality and use of signal functions, over the past three months, in the provision of EmOC in Midigo Health Centre IV by June 2017. Secondly, it was to establish lived experiences of mothers who received EmOC services. Materials and Methods: Purely qualitative phenomenological design was used. Sample of six mothers, six midwives and health facility in-charge were used. WHO Signal function observation tool was used to assess the functionality of the facility Results: Midigo HC IV was categorized as NON-EmOC facility. It felt short of both WHO and Uganda national standards. This was due to policy related issues arising from failure to post medical officers and anesthetist to the facility at that time. Concerning the quality and use of signal functions; 5 out of nine signal functions (55.6%) were performed in the past three months. For lived experiences; 66.7% of the mothers reported poor perceived quality of care and 66.7% were dissatisfied with the services they got. Conclusion: Based on the study finding, Midigo Health Centre IV is still a Non- EmOC Health Facility, falling short of both WHO and Uganda national standards