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

Aim: Staffing is believed to have a profound influence on reducing maternal mortality and severe maternal morbidity. This research aims to examine the relationship between staffing characteristics and severe maternal outcomes.

Methods: We conducted a retrospective cross-sectional study analyzing data from deliveries and staffing at eleven maternity units in tertiary hospitals across the Java region of Indonesia.

Results: The study revealed significant associations between staffing characteristics and severe maternal outcomes. Maternity units with a higher nurse-to-birth ratio had a 52% reduction in the odds of severe maternal outcomes (OR = 0.476; 95% CI: 0.307-0.739). Conversely, units with a higher midwife-to-birth ratio were associated with a 1.8-fold increase in the odds of severe maternal outcomes (OR = 1.809; 95% CI: 1.070-3.059). The likelihood of severe maternal outcomes decreased 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 underscore the important role of healthcare workers in maternal healthcare at the tertiary level. Further research is recommended to support evidence-based policies for developing safe staffing standards within the maternal healthcare framework.