Staffing characteristics and their associations with the severe maternal outcomes at indonesian tertiary hospitals

Aim: Staffing is believed to have a profound influence on the reduction of maternal mortality and severe maternal morbidity. Our research aims to examine the relationship between staffing characteristics and severe maternal outcomes. Methods: We conducted a retrospective cross-sectional study analyzing the data of deliveries and staffing from the eleven maternity units at the tertiary hospitals in the Java region of Indonesia. Results: The present study revealed that staffing characteristics were significantly associated with severe maternal outcomes. Maternity units with a higher nurse to birth ratio reduced the odds of severe maternal outcomes by 52% (OR = 0.476; 95% CI: 0.307–0.739). However, admission to units with a higher midwife to birth ratio increased the odds of experiencing severe maternal outcomes by 1.8 times (OR = 1.809; 95% CI: 1.070–3.059). The likelihood of severe maternal outcomes in maternity units is reduced by 52% for every additional year of nursing experience (OR = 0.476; 95% CI: 0.304–0.745), and by 69% for every additional year of midwifery experience (OR = 0.313; 95% CI: 0.200–0.491). Conclusions: The findings signify the prominent role of healthcare workers in maternal healthcare at the tertiary level. A further study is recommended to provide more support for the evidence-based policy in relation to developing safe staffing standards within the maternal healthcare framework.