Examining barriers to providing good quality postnatal care:A mixed-methods study of global configurations of care and local clinical practice adaptations in Tanzania and Guinea. Onderzoek naar barrières voor het aanbieden van kwalitatief hoogstaande postnatale zorg: een mixed-methods studie van globale zorgconfiguraties en aanpassingen lokale klinische praktijken in Tanzania en Guinée.

Many women die during pregnancy and childbirth around the worldand this problem is most urgent in low-resource contexts such assub-Saharan Africa. Close monitoring of women and babies duringthe first hours and days after childbirth (the postnatal period) cansave many lives. More than half of births in low-resource countriesnow occur in health facilities, which should make it easier to providepostnatal monitoring and treatment if necessary. However, manywomen are not receiving even basic postnatal care, such as stayinglong enough in the facility, or being checked before discharge. We donot have a good understanding of why the basic protocols forpostnatal monitoring are not followed. In this project, I will review thevarious configurations of postnatal care after a birth in health facilitiesworldwide. Next, I will explore the barriers and enablers to providingpostnatal care monitoring to women before and after discharge fromhealth facilities in Tanzania (a large urban referral hospital) andGuinea (small rural health centers). Quantitative data from patientrecords and qualitative data from interviews with clinicians andwomen will be used. I will summarise these findings to recommendpossible interventions to improve postnatal care in low-resourcesettings. These results will better enable countries and healthfacilities to implement new postnatal care recommendations(expected in 2020) and thus make substantial advancements inmaternal survival and well-being.