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The safety and quality of childbirth in the context of health systems: Mapping maternal health provision in Lebanon

Show simple item record DeJong J. Akik C. El Kak F. Osman H. El-Jardali F.
dc.contributor.editor 2010 2017-10-18T13:35:47Z 2017-10-18T13:35:47Z 2010
dc.identifier 10.1016/j.midw.2010.06.012
dc.identifier.issn 02666138
dc.description.abstract Objective: to provide basic information on the distribution (public-private and geographically) and the nature of maternity health provision in Lebanon, including relevant health outcome data at the hospital level in order to compare key features of provision with maternal-neonatal health outcomes. Design: a self-completion questionnaire was sent to private hospitals by the Syndicate of Private Hospitals in collaboration with the study team and to all public hospitals in Lebanon with a functioning maternity ward by the study team in cooperation with the Ministry of Public Health. Setting: childbirth in an institutional setting by a trained attendant is almost universal in Lebanon and the predominant model of care is obstetrician-led rather than midwife-led. Yet due to a 15-year-old civil war and a highly privatised health sector, Lebanon lacks systematic or publically available data on the organisation, distribution and quality of maternal health services. An accreditation system for private hospitals was recently initiated to regulate the quality of hospital care in Lebanon. Participants: in total, 58 (out of 125 eligible) hospitals responded to the survey (46percent total response rate). Only hospital-level aggregate data were collected. Measurements: the survey addressed the volume of services, mode of payment for deliveries, number of health providers, number of labour and childbirth units, availability of neonatal intensive care units, fetal monitors and infusion rate regulation pumps for oxytocin, as well as health outcome data related to childbirth care and stillbirths for the year 2008. Findings: the study provides the first data on maternal health provision from a survey of all eligible hospitals in Lebanon. More than three-quarters of deliveries occur in private hospitals, but the Ministry of Public Health is the single most important source of payment for childbirth. The reported hospital caesarean section rate is high at 40.8percent. Essential equipment for safe maternal and newborn health care is widely available in Lebanon, but over half of the hospitals that responded lack a neonatal intensive care unit. The ratio of reported numbers of midwives to deliveries is three times that of obstetricians to deliveries. Key conclusions and implications for practice: there is a need for greater interaction between maternal-neonatal health, health system specialists and policy makers on how the health system can support both the adoption of evidence-based interventions and, ultimately, better maternal and perinatal health outcomes. © 2010.
dc.format.extent Pages: (549-557)
dc.language English
dc.publisher OXFORD
dc.relation.ispartof Publication Name: Midwifery; Publication Year: 2010; Volume: 26; no. 5; Pages: (549-557);
dc.source Scopus
dc.title The safety and quality of childbirth in the context of health systems: Mapping maternal health provision in Lebanon
dc.type Article
dc.contributor.affiliation DeJong, J., Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
dc.contributor.affiliation Akik, C., Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
dc.contributor.affiliation El Kak, F., Department of Health Behavior and Education, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
dc.contributor.affiliation Osman, H., Department of Health Behavior and Education, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
dc.contributor.affiliation El-Jardali, F., Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107 2020 Beirut, Lebanon
dc.contributor.authorAddress El-Jardali, F.; Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, P.O. Box 11-0236, Riad El Solh, 1107 2020 Beirut, Lebanon; email:
dc.contributor.authorCorporate University: American University of Beirut; Faculty: Faculty of Health Sciences; Department: Health Management and Policy;
dc.contributor.authorDepartment Health Management and Policy
dc.contributor.authorFaculty Faculty of Health Sciences
dc.contributor.authorInitials DeJong, J
dc.contributor.authorInitials Akik, C
dc.contributor.authorInitials El Kak, F
dc.contributor.authorInitials Osman, H
dc.contributor.authorInitials El-Jardali, F
dc.contributor.authorReprintAddress El-Jardali, F (reprint author), Amer Univ Beirut, Fac Hlth Sci, Dept Hlth Management and Policy, POB 11-0236, Beirut 11072020, Lebanon.
dc.contributor.authorUniversity American University of Beirut
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dc.description.citedCount 4
dc.description.citedTotWOSCount 7
dc.description.citedWOSCount 7
dc.format.extentCount 9
dc.identifier.coden MIDWE
dc.identifier.pubmedID 20691519
dc.identifier.scopusID 77956986437
dc.relation.ispartOfISOAbbr Midwifery
dc.relation.ispartOfIssue 5
dc.relation.ispartofPubTitle Midwifery
dc.relation.ispartofPubTitleAbbr Midwifery
dc.relation.ispartOfVolume 26
dc.source.ID WOS:000282156800013
dc.type.publication Journal
dc.subject.otherAuthKeyword Health system
dc.subject.otherAuthKeyword Maternal health
dc.subject.otherAuthKeyword Safety
dc.subject.otherIndex adult
dc.subject.otherIndex article
dc.subject.otherIndex delivery
dc.subject.otherIndex female
dc.subject.otherIndex health care delivery
dc.subject.otherIndex health care quality
dc.subject.otherIndex health service
dc.subject.otherIndex human
dc.subject.otherIndex Lebanon
dc.subject.otherIndex maternal welfare
dc.subject.otherIndex midwife
dc.subject.otherIndex newborn
dc.subject.otherIndex organization and management
dc.subject.otherIndex pregnancy
dc.subject.otherIndex pregnancy outcome
dc.subject.otherIndex safety
dc.subject.otherIndex statistics
dc.subject.otherIndex Adult
dc.subject.otherIndex Delivery, Obstetric
dc.subject.otherIndex Female
dc.subject.otherIndex Health Services Accessibility
dc.subject.otherIndex Health Services Needs and Demand
dc.subject.otherIndex Humans
dc.subject.otherIndex Infant, Newborn
dc.subject.otherIndex Lebanon
dc.subject.otherIndex Maternal Health Services
dc.subject.otherIndex Maternal Welfare
dc.subject.otherIndex Midwifery
dc.subject.otherIndex Pregnancy
dc.subject.otherIndex Pregnancy Outcome
dc.subject.otherIndex Private Sector
dc.subject.otherIndex Public Sector
dc.subject.otherIndex Quality of Health Care
dc.subject.otherIndex Safety Management
dc.subject.otherIndex Young Adult
dc.subject.otherKeywordPlus CESAREAN-SECTION RATES
dc.subject.otherKeywordPlus OF-CARE
dc.subject.otherKeywordPlus POLICY ENVIRONMENT
dc.subject.otherKeywordPlus NEWBORN
dc.subject.otherKeywordPlus INTERVENTIONS
dc.subject.otherKeywordPlus ACCREDITATION
dc.subject.otherKeywordPlus STRATEGIES
dc.subject.otherKeywordPlus HOSPITALS
dc.subject.otherKeywordPlus COUNTRIES
dc.subject.otherKeywordPlus SERVICES
dc.subject.otherWOS Nursing

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