Improving quality of care during labour and childbirth and in the immediate postnatal period.

Quality of care during labour and childbirth and in the immediate postnatal period is important in ensuring healthy maternal and newborn survival. A narrative review of existing quality frameworks in the context of evidence-based interventions for essential care demonstrates the complexities of quality of care and the domains required to provide high quality of care. The role of the care provider is pivotal to optimum care; however, providers need appropriate training and supervision, which should include assessment of core competencies. Organisational factors such as staffing levels and resources may support or hinder the delivery of optimum care and should be observed during any monitoring. The woman's perspective is central to all quality of care strategies; her opinion should be sought where possible. The importance of assessing and monitoring quality of care during such a critical period should be appreciated. A number of quality frameworks offer organisations with a foundation on which they can deliver high quality care.