Childbirth in Palestine.
OBJECTIVE
This study describes staffing, caseloads and reported routine practices for normal childbirth in Palestinian West Bank (WB) governmental maternity facilities and compares these practices with evidence-based care.


METHODS
Data on routine childbirth practices in all eight governmental hospitals were obtained through interviews with head obstetricians and midwives. Data on staffing and monthly number of births were collected by phone or personal interview from all 37 WB hospitals.


RESULTS
Forty-eight percent of WB deliveries took place in crowded and understaffed governmental hospitals. Reported practices were not consistently in line with evidence-based care. Lack of knowledge and structural barriers were reasons for this gap.


CONCLUSIONS
The implications of limiting unnecessary interventions in the normal birth process are particularly important in a context of limited access and scarce resources. More skilled birth attendants and a universal commitment to effective care are needed.
Wick
L
L
Institute of Community and Public Health/Birzeit University, Box 154, Ramallah, West Bank, Occupied Palestinian Territory. lwick@birzeit.edu
Mikki
N
N
Giacaman
R
R
Abdul-Rahim
H
H
D000701:Analgesics, Opioid / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003441:Crowding; D036861:Delivery, Obstetric / Q000191:economics / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D005260:Female; D019983:Guideline Adherence; D006771:Hospitals, Maternity / Q000458:organization & administration* / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008614:Meperidine / Q000627:therapeutic use; D008877:Middle East; D008880:Midwifery / Q000706:statistics & numerical data; D010120:Oxytocics / Q000627:therapeutic use; D010121:Oxytocin / Q000627:therapeutic use; D010561:Personnel Staffing and Scheduling; D010820:Physicians / Q000600:supply & distribution; D011247:Pregnancy; D017149:Private Sector / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D016526:Workload
D000701:Analgesics, Opioid; D010120:Oxytocics; D010121:Oxytocin; D008614:Meperidine