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Maternal health care professionals’ experiences and views on the use of obstetric ultrasound in Rwanda: A cross-sectional study
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology. Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.ORCID iD: 0000-0003-2985-1135
School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology. School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.ORCID iD: 0000-0001-8166-4527
Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology.ORCID iD: 0000-0003-3391-2308
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2021 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 21, no 1, article id 789Article in journal (Refereed) Published
Abstract [en]

Background: This study, undertaken in Rwanda, aimed to investigate health professionals’ experiences and views on the following topics: current clinical guidelines for ultrasound from second trimester at the clinic, regional and national levels, and adherence to clinical guidelines; medically indicated ultrasound examinations; non-medical use of ultrasound including ultrasounds on maternal request; commercialisation of ultrasound; the value of ultrasound in relation to other clinical examinations in pregnancy; and ultrasound and medicalisation of pregnancy.

Methods: A cross-sectional design was adopted. Health professionals providing antenatal care and delivery services to pregnant women in 108 health facilities were invited to complete a survey, which was developed based on the results of earlier qualitative studies undertaken as part of the CROss Country Ultrasound Study (CROCUS).

Results: Nine hundred and seven health professionals participated: obstetricians/gynecologists (3.2%,) other physicians (24.5%), midwives (29.7%) and nurses (42.7%). Few physicians reported the existence of clinical guidelines at clinic, regional or national levels in Rwanda, and guidelines were moderately adhered to. Three obstetric ultrasound examinations were considered medically indicated in an uncomplicated pregnancy. Most participants (73.0%) were positive about obstetric ultrasound examinations on maternal request. Commercialisation was not considered a problem, and the majority (88.5%) agreed that ultrasound had contributed to medicalisation of pregnancy.

Conclusions: Findings indicate that clinical guidelines for the use of obstetric ultrasound are limited in Rwanda. Non-medically indicated obstetric ultrasound was not considered a current problem at any level of the healthcare system. The positive attitude to obstetric ultrasound examinations on maternal request may contribute to further burden on a maternal health care system with limited resources. It is essential that limited obstetric ultrasound resources are allocated where they are most beneficial, and clearly stated medical indications would likely facilitate this.

Place, publisher, year, edition, pages
BioMed Central, 2021. Vol. 21, no 1, article id 789
Keywords [en]
Clinical guidelines, Commercialisation, Epidemiology, Gynecologists, Health professionals, Medicalisation, Midwives, Nurses, Obstetricians, Obstetrics, Pregnancy, Questionnaire, Rwanda, Ultrasonography
National Category
Obstetrics, Gynecology and Reproductive Medicine Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-186843DOI: 10.1186/s12913-021-06758-wISI: 000683718400002Scopus ID: 2-s2.0-85112347099OAI: oai:DiVA.org:umu-186843DiVA, id: diva2:1588138
Available from: 2021-08-26 Created: 2021-08-26 Last updated: 2022-09-15Bibliographically approved

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Mogren, IngridSemasaka Sengoma, Jean PaulHolmlund, SophiaBergström, Cecilia

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Obstetrics, Gynecology and Reproductive MedicinePublic Health, Global Health, Social Medicine and Epidemiology

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