Current evidence on basic emergency obstetric and newborn care services in Addis Ababa, Ethiopia; a cross sectional studyReport as inadecuate




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BMC Pregnancy and Childbirth

, 14:354

Pregnancy and childbirth in low and middle income countries

Abstract

BackgroundEmergency obstetric and neonatal care EmONC is a high impact priority intervention highly recommended for improving maternal and neonatal health outcomes. In 2008, Ethiopia conducted a national EmONC survey that revealed implementation gaps, mainly due to resource constraints and poor competence among providers. As part of an ongoing project, this paper examined progress in the implementation of the basic EmONC BEmONC in Addis Ababa and compared with the 2008 survey.

MethodsA facility based intervention project was conducted in 10 randomly selected public health centers HCs in Addis Ababa and baseline data collected on BEmONC status from January to March 2013. Retrospective routine record reviews and facility observations were done in 29 HCs in 2008 and in10 HCs in 2013. Twenty-five providers in 2008 and 24 in 2013 participated in BEmONC knowledge and skills assessment. All the data were collected using standard tools. Descriptive statistics and t-tests were used.

ResultsIn 2013, all the surveyed HCs had continuous water supply, reliable access to telephone, logbooks and phartograph. Fifty precent of the HCs in 2013 and 34% in 2008 had access to 24 hours ambulance services. The ratio of midwives to 100 expected births were 0.26 in 2008 and 10.3 in 2013. In 2008, 67% of the HCs had a formal fee waiver system while all the surveyed HCs had it in 2013. HCs reporting a consistent supply of uterotonic drugs were 85% in 2008 and 100% in 2013. The majority of the providers who participated in both surveys reported to have insufficient knowledge in diagnosing postpartum haemorrhage PPH and birth asphyxia as well as poor skills in neonatal resuscitation. Comparing with the 2008 survey, no significant improvements were observed in providers’ knowledge and competence in 2013 on PPH management and essential newborn care p > 0.05.

ConclusionThere are advances in infrastructure, medical supplies and personnel for EmONC provision, yet poor providers’ competences have persisted contributing to the quality gaps on BEmONC in Addis Ababa. Considering short-term in-service trainings using novel approaches for ensuring desired competences for large number of providers in short time period is imperative.

KeywordsAssessment Basic Care Emergency Knowledge Neonatal Obstetric Skills AbbreviationsAMTSLActive Management of Third Stage Labour

BEmONCBasic emergency obstetric and neonatal care

EmONCEmergency obstetric and neonatal care

HCHealth center

FMOHFederal Ministry of Health

MDGMillennium development goal

PPHPostpartum haemorrhage

WHOWorld Health Organization.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2393-14-354 contains supplementary material, which is available to authorized users.

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Author: Alemnesh H Mirkuzie - Mitike Molla Sisay - Alemnesh Tekelebirhan Reta - Mulu Muleta Bedane

Source: https://link.springer.com/



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