Indicators for availability, utilization, and quality of emergency obstetric care in Ethiopia, 2008.

Authors: Admasu K,Haile-Mariam A,Bailey P,
Address: Federal Ministry of Health, Addis Ababa, Ethiopia.
Journal: Int J Gynaecol Obstet.


Publication: 2011 Oct;115(1):101-5. doi: 10.1016/j.ijgo.2011.07.010. Epub 2011 Sep 8.

abstract

OBJECTIVE:

To report on the availability and quality of emergency obstetric and newborn care (EmONC) in Ethiopia.

METHODS:

All licensed hospitals and health centers were visited and standard questionnaires were administered. In addition, a nonrandom systematic sample was taken of recent cesarean deliveries, partographs, and maternal deaths-and these cases were systematically reviewed. Health facilities were geocoded using geographic positioning system devices.

RESULTS:

Too few facilities provided EmONC to meet the UN standards of 5 per 500,000 population, both nationally and in all but 2 regions. Only 7% of deliveries took place in institutions of any type, and only 3% in facilities that routinely provided all the signal functions. Only 6% of women with obstetric complications were treated in any health facility, half of whom were treated in fully functional EmONC facilities. Nationwide, 0.6% of expected deliveries were by cesarean. The mortality rate for women with serious obstetric complications (case fatality rate) was 2%. The cause of death was unknown in 10% of cases, and 21% were due to indirect causes (primarily malaria, anemia, and HIV-related).

CONCLUSION:

None of the Indicators met UN standards. Ethiopia faces many challenges--not least geography--with regard to improving EmONC. Nevertheless, the government places high priority on improvement and has taken (and will continue to take) action to achieve Millennium Development Goals 4 and 5. This comprehensive survey serves both as a road map for planning strategies for improvement and as a baseline for measuring the impact of interventions.

Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.



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