METHODS
This is an ongoing descriptive observational
study initiated in November
of 2009 at Haydom Lutheran Hospital:
a rural referral hospital in Northern
Tanzania. Research assistants (observers)
are continuously present in the laborward
to observe the routine practice
of health care providers in the delivery
room as well as postnatally in an adjacent
neonatal area through the initial
24 postnatal hours. The observers work
in3shiftsover24hours.Threeobservers
cover each shift; 2 are always located in
the labor ward or in the theater, and 1 in
the adjacent neonatal area. Altogether,14 local women have been trained to
observe the performance of the health
care workers related to the deliveries
and the newborns. Observations are
timed by using a stop watch, and the
findings are recorded on a data collection
form immediately after the delivery
(Table 1). The research assistants
also review the partograms that are
filled out by the birth attendants and
the responsible midwives.