Quality assessment of midwives performance in prenatal cares in urban health centers in Mashhad, Iran

To determine the quality of midwive's performance in delivering prenatal cares in urban health centers in Mashhad in 2001. In this descriptive study, the performance of 37 midwives from 26 urban health centers (selected by multi-stage random sampling) was observed on three separate occasions. Data were collected by administrating a self-report questionnaire dealing with personal characteristics of the midwives and an observation form used for assessing the quality of prenatal care based on the existing prenatal care guidelines. Data analysis included chi-square and T- tests and was performed using the SPSS package. In this study, the practice score was good in 18.5% of the midwives, while 70% showed moderate, and 11.5% showed poor performance. Only 55.8% of prenatal care items were performed appropriately., referral for laboratory tests, fetal heart rate auscultation, control of vaccination status, estimating the date of delivery and history taking were good in most cases, whereas physical examination, assessment of common complaints, consultation and recommendation for the place of delivery were at an undesirable level. It seems that certain areas of prenatal care, such as physical examination and assessment of common complaints, which are important in the diagnosis and treatment of obstetric disorders, are largely neglected in urban health centers. Hence to address these problems and improve practice in prenatal care, midwives and other health workers must receive further training. The quality of prenatal care in urban health centers must be supervised and monitored accurately.