Quality of Intrapartum Care in Public Health Centers of Addis Ababa City, Ethiopia: A Mixed-Methods Study

Objective To assess the quality of intrapartum care in public health centres in Addis Ababa, Ethiopia. Methods An explanatory sequential mixed-methods study was conducted in 50 public health centers between January and April 2021. Quantitative data were collected through interviews with 500 postpartum women and a review of delivery charts using 34 indicators derived from World Health Organization (WHO) standards. Qualitative data were obtained through in-depth interviews with 20 midwives and 13 health center managers. Quantitative data were analyzed descriptively, while qualitative data were analyzed thematically. Results Overall, 53.6% of women received quality intrapartum care. Proper documentation of obstetric history and examination at admission was observed in 55.8% and 64.0% of cases, respectively. Evidence-based labor monitoring and management were documented in 51.8% of cases, while only 33.4% of newborns received essential newborn care. Qualitative findings identified high workload, weak supervision, and limited accountability as key barriers to guideline adherence. Conclusion The quality of intrapartum care in public health centers in Addis Ababa remains suboptimal. Strengthening adherence to evidence-based guidelines through updated protocols, targeted training, supportive supervision, and accountability mechanisms is essential to improve maternal and newborn outcomes