Author(s): Admasu K, HaileMariam A, Bailey P
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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.
This article was published in Int J Gynaecol Obstet
and referenced in Journal of Addiction Research & Therapy