Assessment of Patterns of Utilization and Quality of Emergency Obstetric Care Services in South West Shoa Zone of Oromia Regional Sate, Ethiopia.
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Date
2011-07
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Addis Ababa University
Abstract
Background: Though one way of reducing maternal deaths, is by improving the availability, accessibility and use of services for the treatment of obstetric complications that arise during pregnancy and childbirth; still, few facilities are providing the services. 80% of women are dying from direct emergency obstetrics complications.
Objectives: To assess the availability, patterns of utilization and quality of emergency obstetric care services in health facilities as a measure of progress towards maternal mortality reduction and set a base line for the zone.
Methods: A cross-sectional institution based survey was conducted in 12 districts of South West Shoa zone of Oromia regional state. Twelve health centers and one hospital were envolved in the study. EmOC facilities` data of one year(January1, 2010-December30, 2010)were obtained by reviewing obstetric, gynacological and surgical log book. Clients and key informatics were interviewed
Results : There was one comprehensive emergency obstetric care (CEmOC) facility per1,088,06 in the zone. 562 obstetric complication cases were served in CEmOC facility.413(80%) of cases were direct obstetric complications which make the met need for EMOC6.6% in the zone with the highest for urban (22.4%) where the CEmOC is founded and the lowest 0.72% for rural district . Among 41,346 estimated deliveries 447 (1.08%) were c/sdeliveries;298(66.7%) were due to absolute maternal indications. The crude direct obstetric case fatality rate was 14(3.39%) and the causes were: uterine ruptue, PIH, hemmorehge(APH and PPH),obstructed labor,and purepureal sepsis in which each cases account for(28.6%),3(21.4%),3(21.4%),2(14.3%),and 2(14.3%) respectively.
Conclusion and Recommandations: Majority of women are inaccessible to EmOC or lifesaving services.Although they utilize the EmOC facilty through different difficulities, they encounter startiling facility obstetric case fatality. The supportive supervision list lacks EmOCservices. Patients (sepsis and PIH cases) complained high waiting time before admission. Therefore, maternal health should not be only political agenda, and quality EmOC services should be available at reasonable place and time. Further studies on emergency obstetric services starting from health personnel pre service training to community level is mandatory.
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Reducing Maternal Deaths