Table 3.

Women’s suggestions related to the provision of care

3rd level – WHO Standards	2nd level – Quality statements	1st level – Women’s suggestions	On total women (N = 392)	On total comments (N = 966)
Standard 1: every woman and newborn receive routine, evidenced-based care and management of complications during labour, childbirth, post -partum, according with WHO Guidelines	1.1a Timely appropriate care during labour and childbirth	Provide different options for pain relief during labour and childbirth	17 (4.3)	17 (1.8)
	1.1b Routine care for newborn immediately after birth	Encourage skin to skin contact for at least 1 h after birth	4 (1.0)	4 (0.4)
		Perform umbilical cord clamped after 1–3 min	1 (0.3)	1 (0.1)
	1.1c Routine postnatal care for mother and newborn	Improve breastfeeding counselling and support from a skilled health care provider	24 (6.1)	24 (2.5)
	1.2 Interventions for preclampsia/eclampsia according to WHO GL		0	0
	1.3 Interventions for PPH according to WHO GL		0	0
	1.4 Interventions for delay/obstructed labour according to WHO GL	Improve management of obstructed labour	1 (0.3)	1 (0.1)
	1.5 Newborns who are not breathing receive stimulation and resuscitation within 1 min after birth according to WHO GL		0	0
	1.6a Appropriate care for preterm and small babies according to WHO GL		0	0
	1.7a Interventions for women with or at risk of infection according to WHOGL		0	0
	1.7b Antibiotic treatment for newborns with suspected infection or risk factors according to WHO GL		0	0
	1.8 Precautions for preventing hospital-acquired infections		0	0
	1.9 No unnecessary or harmful practices during labour, childbirth, post-partum	Reduce medicalisation	1 (0.3)	1 (0.1)
Standard 2: the health information system enables use of data to ensure early, appropriate action to improve the care of every woman and newborn	2.1 Complete, accurate, standardized medical record		0	0
	2.2 Mechanism for data collection, analysis and feedback for monitoring and improving performance around childbirth		0	0
Standard 3: every woman and newborn with condition that cannot be dealt with effectively with the available resources is appropriately referred	3.1 Assessment to determine whether referral is required, and the decision to refer is made without delay		0	0
	3.2 If needed, the referral follows a pre-established plan that can be implemented without delay		0	0
	3.3 For every referral within or between health facilities: appropriate information exchange and feedback to relevant health care staff		0	0
Extra	Not included in WHO Standards	Increase access to labour/birth in water	7 (1.8)	7 (0.7)
		Increase access to home birth with skilled attendant, coordinated by the health facility	1 (0.3)	1 (0.1)
		Create perineal rehabilitation clinics	1 (0.3)	1 (0.1)
		Create a system for the mother to call for help from different type of staff when in bed during the post-delivery (ie, emergency button to call for midwives separate from emergency button for nurses)	1 (0.3)	1 (0.1)

Abbreviations: GL Guidelines, PPH Post-partum haemorrhage, WHO World Health Organization