Compliance with comprehensive delivery practices in second-level hospitals in Ecuador: a contribution to public policy

Abstract

Background: Ministry of Public Health of Ecuador recommends the application of comprehensive childbirth practices in all normal deliveries; however, the level of compliance with these by obstetric and medical students at the end of their career is not known. Objective: To determine if the internship students of medicine and obstetrics careers at Central University of Ecuador (UCE) comply with the integral practices of childbirth. Methods: Cross-sectional study in 365 births attended by internship students of medicine and obstetrics careers at UCE in five general hospitals in Ecuador. Compliance with comprehensive delivery practices was evaluated by observing and filling out a pre-established form on compliance with each of the parameters of the standards (newborn drying, early attachment, newborn identification, breastfeeding, joint accommodation and time cord clamping). The percentage of overall compliance and with each of the parameters and of the total compliance were calculated. Results: 361 people (49.8% Obstetrics, 42.4% Medicine and 5.7% professionals) attended the deliveries. General compliance with the comprehensive delivery practices was observed in > 86%, without significant differences with respect to the group that attended the delivery. All qualitative parameters were fulfilled in more than 95%; but the cut of the umbilical cord at three to four minutes was completed in 49.6%. Conclusions: Practitioner students from Obstetrics and Medicine met the standards in a high percentage, but need to reinforce the practice of optimal time for clamping the umbilical cord after birth.