Maternal health care professionals’ experiences and views on the use of obstetric ultrasound in Rwanda: A cross-sectional study

Mogren, Ingrid; Ntaganira, Joseph; Sengoma, Jean Paul Semasaka; Holmlund, Sophia; Small, Rhonda; Pham Thi, Lan; Kidanto, Hussein Lesio; Ngarina, Matilda; Bergström, Cecilia; Edvardsson, Kristina

doi:10.1186/s12913-021-06758-w

Table 4 Health professionals’ responses^a to statements about ultrasound by background characteristics and other selected variables

From: Maternal health care professionals’ experiences and views on the use of obstetric ultrasound in Rwanda: A cross-sectional study

Background variables	Maternity care providers may trust ultrasound above clinical examinations in pregnancy			Increasing use of obstetric ultrasound may result in less focus on clinical skills
	Agree or strongly agree	Disagree or strongly disagree	p-value^b	Agree or strongly agree	Disagree or strongly disagree	p-value^b
	n (%)	n (%)		n (%)	n (%)
Health professional/workplace (n)	*(905)*			*(902)*
Physicians in hospitals	125 (49.8)	84 (33.5)	*0.014*	93 (37.3)	112 (45.0)	0.107
Midwives/nurses in hospitals	196 (59.0)	109 (32.8)		110 (33.1)	183 (55.1)
Nurses/midwives in health centres	201 (62.4)	103 (32.0)		132 (41.1)	158 (49.2)
Age (n)	*(902)*			*(899)*
≤ 35 years	319 (60.5)	162 (30.7)	0.190	191 (36.5)	268 (51.1)	0.862
> 35 years	203 (54.1)	132 (35.2)		141 (37.6)	185 (49.3)
Public/Private health care^c (n)	*(902)*			*(899)*
Public	409 (58.3)	225 (32.1)	0.869	269 (38.5)	342 (49.0)	*0.027*
Private	43 (60.6)	21 (29.6)		34 (47.9)	29 (40.8)
Both public and private	69 (53.1)	49 (37.7)		31 (23.8)	80 (61.5)
Public/Private health care^d (n)	*(902)*			*(899)*
Public	409 (58.3)	225 (32.1)	0.894	269 (38.5)	342 (49.0)	0.380
Private but also public	112 (55.7)	70 (34.8)		65 (32.3)	109 (54.2)
Performing ultrasound^e (n)	*(904)*			*(901)*
Yes	148 (50.5)	102 (34.8)	*0.001*	104 (35.7)	136 (46.7)	*0.035*
No	374 (61.2)	194 (31.8)		230 (37.7)	317 (52.0)
Indicated ultrasound exams in uncomplicated pregnancy^f	*(897)*			*(894)*
≤ 3	356 (57.4)	205 (33.1)	0.645	224 (36.3)	322 (52.2)	0.260
> 3	162 (58.5)	87 (31.4)		109 (39.4)	126 (45.4)
“Ultrasound is safe to use”^g (n)	*(792)*			*(789)*
Agree or strongly agree	421 (59.4)	225 (31.7)	0.285	259 (36.7)	361 (51.1)	0.961
Disagree or strongly disagree	45 (54.2)	33 (39.8)		31 (37.3)	44 (53.0)
“Pregnant women expect ultrasound at consultation”^h (n)	*(809)*			*(806)*
Agree or strongly agree	348 (62.5)	150 (26.9)	*0.001*	223 (40.3)	271 (48.9)	0.134
Disagree or strongly disagree	121 (48.0)	117 (46.4)		80 (31.7)	147 (58.3)
	The use of ultrasound has contributed to medicalisation of pregnancy
	Agree or strongly agree	Disagree or strongly disagree	p-value^b
	n (%)	n (%)
Health professional/workplace (n)	*(904)*
Physicians at hospitals	191 (76.1)	25 (10.0)	0.150
Midwives/nurses at hospitals	274 (82.5)	26 (7.8)
Nurses/midwives at health centres	270 (84.1)	29 (9.0)
Age (n)	*(901)*
≤ 35 years	432 (82.1)	37 (7.0)	0.171
> 35 years	301 (80.3)	42 (11.2)
Public/Private health care^c (n)	*(901)*
Public	563 (80.4)	61 (8.7)	0.811
Private	58 (81.7)	8 (11.3)
Both public and private	111 (85.4)	11 (8.5)
Public/Private health care^d (n)	*(901)*
Public	563 (80.4)	61 (8.7)	0.457
Private but also public	169 (84.1)	19 (8.5)
Performing ultrasound^e (n)	*(903)*
Yes	225 (76.8)	29 (9.9)	*0.002*
No	509 (83.4)	51 (8.4)
Indicated ultrasound exams in uncomplicated pregnancy^f	*(896)*
≤ 3	502 (81.1)	60 (9.7)	0.200
> 3	227 (81.9)	18 (6.5)
“Ultrasound is safe to use”^g (n)	*(791)*
Agree or strongly agree	584 (82.5)	59 (8.3)	0.174
Disagree or strongly disagree	64 (77.1)	12 (14.5)
“Pregnant women expect ultrasound at consultation”^h (n)	*(808)*
Agree or strongly agree	467 (83.8)	46 (8.3)	0.388
Disagree or strongly disagree	198 (78.9)	26 (10.4)

^aAll five categories of response were included as separate categories in analysis: “Strongly agree”, “Agree”, “Neutral”, “Disagree”, “Strongly disagree”. Response option “neutral” not presented in the table
^bPearson’s Chi-Square test for comparison of difference between categories
^cIncluded in analysis are only participants who reported working either in public or private health care
^dIncluded in analysis are participants who reported working either in public health care solely or working in both public and private health care
^ePerforming ultrasound examinations
^fResponses to question: “In your view, how many ultrasound examinations are medically indicated in an uncomplicated pregnancy”?
^gPre-specified statement: “Ultrasound is safe to use for the pregnant woman and the fetus irrespective of the number of examinations”. Nine hundred and three participants responded to this question. Results for this statement have been previously published [1]
^hPre-specified statement: “Do you feel that pregnant women expect to have an ultrasound during consultations, even when there is no medical indication for ultrasound?”

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ISSN: 1472-6963

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