| Sammanfattning: | The study aimed to measure the performance of delivery centres (DC) and explore
the factors related to performance of DCs. Data were collected using qualitative
methods during December 2009 - January 2010 from six DCs in the slums of Dhaka
city. Findings reveal that the DCs at Magbazar and Kamrangir Char performed 'well'
due to availability of community health workers (CHW) , their emotional support and
caring attitude, regular antenatal care (ANC) visits, convenient location, cleanliness
and free services of the DCs. The DCs at Madertek and Shyampur performed
'average' and Ramna and Kotwali DCs performed poor. Poor performance was
largely due to lack of CHWs, less motivation, frequent dropout due to low
remuneration, and recurrent slum demolition. As women reported, the reasons for
not attending DCs was fear of being referred to the hospital which might compel
them to have a caesarean delivery, lack of comprehensive services at DCs including
doctor-assisted normal deliveries, medicines, and emergency case management.
Neonatal mortality rate in poor performed DCs found to be high. The respondents
suggested that instead of referring women for minor complications, DCs should be
competent of providing supervised skilled service package with basic treatment
during childbirth, tetanus toxoid during ANC and child immunizations and postnatal
care.
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