Negligence in data recording during institutional birth: exploring health workers' perspectives on the barriers and enablers of data documentation practices.

backgroundThe availability of well-documented records during labor and delivery is essential for monitoring childbirth and ensuring positive outcomes for mothers and newborns. However, recent research in northwestern Ethiopia shows that data recording during these critical periods is inadequately performed. This study explored the barriers and enablers of data recording practices during institutional childbirth in this region.

methodsA descriptive qualitative study was conducted in six health centers in the Wegera district, focusing on three source documents: one facility-level log (the Delivery Register) and two personal records (the Integrated Card and the Women's Folder). An interview guide was used to collect spoken accounts from 14 health workers. The spoken data was transcribed and analyzed using thematic framework analysis, assisted by ATLAS.ti (version 9.1.3).

resultsThis study identified three primary barriers to recording institutional birth data: organizational, behavioral, and technical. Four key subthemes emerged from the analysis within the organizational barriers category: the workload during childbirth, the lack of supervision of data within personal records, a lack of accountability for recording, and the turnover of trained staff responsible for data management. Behavioral barriers included health workers neglecting data recording and negative attitudes toward documentation. Regarding technical obstacles, the complexity of data recording formats presents challenges, resulting in missing data and errors when transferring data from one source to another. Despite these barriers, the study highlighted enablers, all of which were organizational, including the presence of routine data quality reviews, training, and supervision from the higher officials.

conclusionsThis study examines health workers' perspectives in northwestern Ethiopia on the barriers and enablers to recording birth data, focusing on women's personal records. It shows that weak organizational emphasis on client-level documentation and limited accountability for personal records diminishes motivation and contributes to neglect of crucial data. Busy settings, marked by heavy workloads, staff shortages, and competing priorities, further undermine confidence in maintaining accurate records. Interventions should aim to enhance motivation, build staff self-esteem in documenting under pressure, and foster a sense of professional responsibility. Promoting a positive attitude toward detailed record-keeping is also essential.