Implementation of Evidence-Based Intrapartum Care and its Associated Factors Among Obstetric Care Providers Working in South Ethiopia.

Background: Despite the availability of clear guidelines, evidence from low- and middle-income countries, including Ethiopia, shows persistent gaps in implementing evidence-based intrapartum practices, contributing to high maternal and neonatal morbidity and mortality. In southern Ethiopia, including the Wolaita Zone, where resource constraints are common, the extent of adherence to these practices and factors influencing their implementation is not well understood. Therefore, this study aimed to assess the implementation level of evidence-based intrapartum care practice and its associated factors among obstetric care providers working in hospitals in Wolaita Zone in 2022. Methods: A facility-based cross-sectional study was conducted from August 1-31, 2022, among 332 obstetric care providers in the hospitals of the Wolaita Zone. The data were collected using structured interviewer-administered questionnaires and non-participatory observation with a standard checklist supplemented with record review. Data were entered into EpiData version 4.6.0.2 and then exported to Stata Version 15 for analysis. Binary logistic regression analyses were conducted to identify factors associated with evidence-based intrapartum care among obstetric care providers. An adjusted odds ratio (AOR) with a 95% confidence interval was reported. Results: The implementation of evidence-based intrapartum practice was 52.5% [95% CI (47.1%-57.9%)]. Work experience >5 years [AOR:1.74;95%CI (1.04,2.91)], knowledge [AOR:1.77; 95% CI (1.06,2.95)], in-service training [AOR = 1.83; 95% CI (1.05,3.17)], access to EBP guidelines [AOR:1.70; 95% CI (1.01,2.85)], and managerial support [AOR:3.1; 95% CI (1.11,8.67)] were associated with the implementation of evidence-based intrapartum care. Conclusion: Evidence-based intrapartum care practice implementation was low in the study area. Years of work experience, knowledge, in-service training, availability of EBP guidelines, and support from managers were the factors with a significant association with evidence-based intrapartum care practice. Strengthening these enabling factors may help creating an environment that facilitates greater adherence to recommended intrapartum care practices, thereby improving maternal and newborn outcomes.