Health care staffing and maternal health outcomes in Terego District, Uganda

Abstract

Maternal mortality is still a major public health concern for Uganda and especially this problem in rural areas such as Terego. Although it has universally been acknowledged that health staffing is a significant factor that influences maternal health, the unique ways that staffing-related factors (such as adequacy, motivation, and training) impact on these results in underserved contexts in Uganda has not been investigated. This work investigated impact of healthcare staffing on maternal health outcomes in Terego District, Uganda. Three objectives: The study aimed at: (1) determining the effect of healthcare staff adequacy on maternal health; (2) determining what role motivated staff play in maternal health improvements; (3) knowledge on healthcare workers’ skills and training to improve maternal health outcomes. Methodology METHODS AND METHODS The methodology used mixed-methods and includes quantitative and qualitative data collection. Descriptive, correlational design was employed as the part of the quantitative part with the collection of data from 136 HCWs, district health managers, health unit management committee members, village health teams and community beneficiaries by the way of a structured questionnaire. The qualitative data were gathered through semi-structured interviews and analysed in a thematic manner. The data were examined using descriptive statistics, Pearson correlation, and SPSS regression analysis and thematic narrative analysis. Separate associations between staffing levels were identified for each staff level variable via the study. Staff adequacy did not significantly correlate with maternal health outcomes (r = 0.034, p = 0.696), owing to widespread and consistent shortages among all facilities. Staff motivation showed a statistically significant positive association with outcomes (r = 0.333, p < 0.001), representing 11.1% of the variance. Staff training and skills were found to be the largest predictor of maternal health outcomes (r = 0.400; p < 0.001), accounting for 16.0% of variance. Based on qualitative research finding, these problems were confirmed, indicating acute shortages of skilled staff with low pay and poor living conditions, as well as urgent training in emergency obstetric and neonatal care. Keywords: maternal health, healthcare staffing, staff motivation, staff training and health outcomes.