Table 4 Validation Results on the Content of Child Birth Care Quality indicators in Northern Ethiopia (N = 455)
Indicators | Women’s reported prevalence (%) | True prevalence (%) | Sensitivity of women’s self-report (95% CI) | Specificity of women’s self-report (95% CI) | Population survey estimate (Pr) | AUC (95% CI) | IF | Criteria met |
|---|---|---|---|---|---|---|---|---|
HIV test offered | 23.93 | 34.43 | 92.56(66.13–99.82) | 93.18(81.34–98.57) | 36.34 | 0.92(0.81–0.97) | 1.06 | Both |
Received HIV test | 40.17 | 44.26 | 93.75(69.77–99.84) | 80.95(65.88–91.40) | 52.11 | 0.87(0.77–0.95) | 1.18 | Both |
Took temperature during labor | 62.64 | 55.38 | 87.70(82.99–91.49) | 66.50(59.56–72.96) | 63.52 | 0.77(0.73–0.81) | 1.15 | Both |
Took blood pressure at labor | 83.96 | 76.92 | 91.71(88.32–94.38) | 36.19(27.04–46.15) | 85.27 | 0.62(0.58–0.67) | 1.11 | Both |
Provider washed hands with soap/ antiseptic before initial examination | 36.70 | 33.85 | 53.25(45.05–61.32) | 70.11(64.58–75.22) | 37.80 | 0.64(0.59–0.68) | 1.12 | Both |
Vaginal examination performed | 96.26 | 94.07 | 97.20(95.15–98.54) | 14.81(4.19–33.73) | 96.49 | 0.64(0.54–0.70) | 1.03 | Both |
Correct uterotonic received, 1–3 min after birth | 79.34 | 75.38 | 80.47(75.87–84.53) | 16.07(9.81–24.21) | 81.32 | 0.61(0.56–0.67) | 1.08 | Both |
First post-delivery exam, bleeding checked | 80.44 | 77.58 | 87.54(83.63–90.80) | 41.18(31.52–51.36) | 81.10 | 0.64(0.60–0.69) | 1.05 | Both |
Women received pain relief medication | 22.42 | 19.78 | 60.0(49.13–70.19) | 84.93(80.84–88.44) | 23.96 | 0.73(0.69–0.77) | 1.21 | Both |
Clamped and cut cord of newborn when pulsations stopped | 68.13 | 59.78 | 66.18(60.22–71.78) | 27.32(21.0–34.39) | 68.79 | 0.60(0.52–0.64) | 1.15 | Both |
Baby placed immediately skin-to-skin on mother | 81.98 | 80.22 | 87.12(83.25–90.38) | 30.0(20.79–40.57) | 83.73 | 0.60(0.54–0.65) | 1.04 | Both |
Breast feeding initiated within first hour of birth | 86.15 | 76.04 | 88.44(84.59–91.61) | 17.43(10.83–25.87) | 87.01 | 0.63(0.57–0.69) | 1.14 | Both |
Newborn received tetracycline eye ointment | 59.78 | 72.53 | 72.73(67.58–77.46) | 70.4(61.58–78.23) | 60.88 | 0.72(0.68–0.76) | 0.84 | Both |
Two elements of essential newborn care (place skin to skin, & breastfed within first hour) | 71.21 | 61.76 | 77.58(72.25–82.32) | 39.08(31.79–46.75) | 71.21 | 0.60(0.54–0.65) | 1.15 | Both |
Provider discussed exclusive breast feeding | 78.24 | 69.67 | 88.33(84.27–91.65) | 43.48(35.07–52.18) | 78.68 | 0.65(0.61–0.70) | 1.13 | Both |
Provider discussed birth spacing | 64.62 | 62.2 | 84.81(80.1–88.78) | 68.6(61.1.-75.45) | 64.60 | 0.77(0.73–0.81) | 1.04 | Both |
Provider discussed immunization and other prophylaxis | 76.48 | 62.2 | 85.87(81.25–89.71) | 37.79(30.52–45.49) | 76.93 | 0.61(0.57–0.66) | 1.24 | Both |
Provider discussed and reviewed possible complications and readiness plan for mother and newborn | 67.91 | 58.46 | 81.95(76.80–86.38) | 50.79(43.44–58.12) | 68.35 | 0.67(0.63–0.71) | 1.17 | Both |
Provider took urine sample for protein test | 36.48 | 24.18 | 69.09(59.57–77.55) | 73.33(68.33–77.93) | 36.93 | 0.71(0.67–0.75) | 1.53 | AUC |
At the first post-delivery exam, provider took blood pressure | 66.15 | 52.53 | 83.68(78.37–88.13) | 49.54(42.68–56.40) | 67.91 | 0.66(0.61–0.70) | 1.29 | AUC |
At the first post-delivery exam, provider took temperature | 49.67 | 35.38 | 80.75(73.80) | 65.99(60.26–71.39) | 50.55 | 0.74(0.70–0.78) | 1.43 | AUC |
Women asked if they needed pain relief medication | 26.15 | 19.78 | 66.67(55.95–76.26) | 81.64(77.28–85.48) | 27.92 | 0.75(0.71–0.79) | 1.41 | AUC |
Provider discussed self-care and other healthy behaviors | 59.78 | 46.59 | 79.25(73.16–84.50) | 55.97(49.48–62.31) | 60.44 | 0.67(0.63–0.72) | 1.30 | AUC |
Women counseled on balanced diet | 53.41 | 35.16 | 72.5(64.89–79.25) | 56.27(50.40–62.01) | 53.85 | 0.64(0.60–0.69) | 1.53 | AUC |
Provider discussed delayed baby bath until 24 h | 52.31 | 41.32 | 73.94(67.05–80.05) | 59.93(53.78–65.85) | 54.05 | 0.66(0.61–0.70) | 1.31 | AUC |
Provider discussed schedule of next PNC visit | 58.46 | 40.66 | 81.62(75.28–86.92) | 56.30(50.15–62.30) | 59.12 | 0.69(0.65–0.73) | 1.45 | AUC |
4 elements of care provision discussed (EBF, birth spacing, immunization and review complication and readiness plan) | 45.27 | 29.67 | 77.04(69.02–83.83) | 68.13(62.71–73.20) | 45.27 | 0.69(0.65–0.73) | 1.53 | AUC |
Asked about obstetric history | 88.57 | 71.65 | 92.33(88.89–94.98) | 20.93(14.27–28.97) | 88.57 | 0.57(0.53–0.62) | 1.24 | IF |
HIV status checked | 78.68 | 66.59 | 84.49(79.91–88.37) | 32.89(25.50–40.97) | 78.68 | 0.59(0.54–0.63) | 1.18 | IF |
Abdominal examination performed | 96.92 | 93.85 | 97.89(96.04–99.03) | 14.29(4.03–32.67) | 97.14 | 0.55(0.50–0.59) | 1.04 | IF |
Health provider wore sterile gloves for vaginal examination | 92.31 | 80.88 | 92.12(88.88–94.66) | 5.75(1.89–12.90) | 92.53 | 0.53(0.48–0.58) | 1.14 | IF |
Newborn immediately dried and wrapped with towel/ cloth | 87.47 | 75.16 | 88.01(84.09–91.26) | 11.50(6.27–18.87) | 88.12 | 0.52(0.47–0.57) | 1.17 | IF |
Five elements of essential newborn care (dried, skin to skin, clamped cord, breastfed within first hour and received tetracycline ointment) | 27.69 | 22.86 | 38.46(29.09–48.51) | 75.50(70.65–79.91) | 18.90 | 0.56(0.52–0.61) | 0.83 | IF |
The baby was weighed | 83.96 | 87.25 | 85.86(82.03–89.14) | 32.20(20.62–45.64) | 83.56 | 0.59(0.55–0.64) | 0.96 | IF |
The provider ensured a safe and clean care environment for women | 83.96 | 79.12 | 86.39(82.41–89.76) | 24.21(16.0–34.08) | 84.18 | 0.56(0.51–0.60) | 1.06 | IF |
Provider discussed perineal care | 70.99 | 57.36 | 77.01(71.42–81.97) | 36.60(29.81–43.80) | 71.21 | 0.58(0.54–0.63) | 1.24 | IF |
The scale was calibrated and the baby was weighed | 35.48 | 56.65 | 47.51(40.77–54.31) | 30.82(23.75–38.62) | 40.89 | 0.48(0.43–0.53) | 0.72 | No |
Women’s vulva was cleansed | 52.75 | 31.21 | 65.49(57.06–72.26) | 39.62(34.16–45.27) | 61.97 | 0.59(0.54–0.63) | 1.99 | No |