- To educate mothers about safe contraception, exclusive breast feeding and maternal nutrition prior to discharge from hospital.
- To implement the contraceptive usage and to attain inter-pregnancy interval of 18 months in at-least 50% women.
- To improve exclusive breast-feeding practice by 37% as recommended by WHO
In a secondary hospital of Qatar, an audit revealed the usage of contraception in 25% of women. Nearly 29% of women delivered had an Inter Pregnancy interval of less than 18 months. Merely 12% women exclusively breast feed their babies. So, a quality improvement project (QIP) was initiated using QIP methodology to attain contraceptive usage and inter-pregnancy interval of 18 months in at-least 50% women. It also aimed to improve exclusive breast-feeding practice by 37% as recommended by WHO.
Method: QIP methodology (plan, do, study, act) was implemented. Post-natal clinics were started in the post-natal ward by the clinical pharmacist, supervised by physicians. Women delivered between January 2018-June 2019 were offered post-natal education prior to discharge. Privacy and patient confidentiality were maintained during counselling. All myths were clarified and clear instructions on usage, failure rates of the contraceptive methods opted by women were provided. Spouses were also indulged for women requesting for it. All women were educated regarding safe contraception, exclusive breast feeding and maternal nutrition. Data was collected on each visit. Women were followed up at 6 months and 18 months of discharge by phone calls and their electronic data were recorded and assessed. Results were analyzed. Chi square test was used for statistical analysis using online Medcal software.
Results: 2050 patients were counselled over a period of 18 months. 76% (OR 0.17, CI-0.0918 to 0.3148, P=P < 0.0001) women of the counselled women used one of the contraceptive methods. 47.6% (OR 0.1477, CI-0.0918 to 0.3148, P < 0.0001) women practiced exclusive breast feeding for more than 6 months. An interpregnancy interval of more than 18 months was attained in 88% (OR-0.3339, CI-0.1590 to 0.7010, P<0.05) of women. A statistically significant improvement was noted in all the KPIs in comparison to those pre-counselling.
Conclusion: Post-natal education can significantly improve maternal nutrition, contraception, and breast-feeding practice. It should be implemented at all hospitals.