Journal of Gynecology and Obstetrics

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Assessment of Availability, Utilization and Quality of Emergency Obstetric Care in 2014 at Hai District, Northern Tanzania

Received: 20 March 2015    Accepted: 01 April 2015    Published: 10 April 2015
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Abstract

Background: Availability of emergency obstetric and newborn care (EmOC) is one of interventions to reduce maternal and newborn deaths. Maternal and newborn mortality is a public health problem in most developing countries including Tanzania. In these settings, coverage of EmOC is low especially in rural areas, with limited information on availability and use of EmOC services. Objectives: To assess the availability, utilization and quality of emergency obstetric care in Hai district, located at Kilimanjaro region, northern Tanzania. Methods: A cross-sectional survey of 12 health facilities (2 hospitals and 10 primary health care facilities) which provide delivery services in the district was conducted in May- June 2014. Modified AMDD data collection tool was used and it assessed availability of services, supplies and equipments, infrastructure and actual performance of EmOC within the past 3 months prior to the interview. Proportions were used to summarize the data. Results: The two comprehensive EmOC facilities (CEmOC) could provide all the nine required signal functions while none of the basic EmOC facilities (BEmOC) could provide the seven required signal functions. For a population of 214,454 in the district, the total number of health facilities designated to provide EmOC services exceeded the minimum required number which was 1 for CEmOC and 2 BEmOC. The proportion of births taking place in facilities was 65.3% and the met need for emergency obstetric complications was 94.5%. Population based caesarean section rate and the still birth rate were 7.4% and 1.3% respectively. Conclusion: BEmOC facilities, which are the first level of care for majority of women and newborns with complications, need to be strengthened to offer the required medical and surgical interventions to save lives. There is a need to scale-up training of health providers especially at the lower level (dispensaries and health centres) in EmOC as well as to strength supply chain system in order to contribute in attaining the national BEmOC coverage of 70% by December 2015.

DOI 10.11648/j.jgo.20150303.11
Published in Journal of Gynecology and Obstetrics (Volume 3, Issue 3, May 2015)
Page(s) 43-48
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Emergency Obstetric Care, UN Process Indicators, Maternal Mortality, Tanzania

References
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[3] WHO (2011). World health statistics 2011. Geneva: World Health Organization.
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[5] MOHSW (2008). The National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania: 2008-2015. One Plan. RCHS, Directorate of Preventive Services, United Republic of Tanzania, Dar es Salaam, April, 2008.
[6] National Bureau of Statistics (NBS) and ICF Macro: Tanzania Demographic and Health Survey, 2010. Dar es Salaam, Tanzania 2011.
[7] WHO (2009) Monitoring emergency obstetric care. A handbook. WHO, UNFPA, UNICEF & AMDD. Geneva, Switzerland: WHO press. http://whqlibdoc.who.int/publications/2009/9789241547734_eng.pdf
[8] WHO. (2004).Making pregnancy safer: the critical role of the skilled attendant. A joint statement by WHO, ICM and FIGO. Geneva, Switzerland: WHO press
[9] MOHSW (2014). Mid Term Review of the National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania: 2008-2015. One Plan. RCHS, Directorate of Preventive Services, United Republic of Tanzania, Dar es Salaam, April, 2014.
[10] MOHSW (2013). Tanzania Service Availability and Readiness Assessment (SARA) 2012: Final Report. Dar es Salaam, Tanzania, March 2013.
[11] MOHSW (2014). The National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania: 2008-2015. Sharpened One Plan. RCHS, Directorate of Preventive Services, United Republic of Tanzania, Dar es Salaam, April, 2014.
[12] National Bureau of Statistics, Dar es Salaam and Office of Chief Government Statistician, Zanzibar, 2013. 2012 Population and Housing Census. NBS, March 2013.
[13] Kwesigabo G & Mwangu MA. Tanzania’s health system and workforce crisis. , 33(S1), pp.S35–S44. Available at: http://dx.doi.org/10.1057/jphp.2012.55.
[14] Kongnyuy EJ, Hofman J, Mlava G, Mhango C, van den Broek N. Availability, Utilisation and Quality of Basic and Comprehensive Emergency Obstetric Care Services in Malawi. Matern Child Healt J 2009, 13: 687–694.
[15] Ameh C, Msuya S, Hofman J, Raven J, Mathai M, et al. (2012) Status of Emergency Obstetric Care in Six Developing Countries Five Years before the MDG Targets for Maternal and Newborn Health. PLoS ONE 2012, 7(12): e49938. doi:10.1371/journal.pone.0049938
[16] Oyerinde K, Harding Y, Amara P, Kanu R, Shoo R, et al. et al. The status of maternal and newborn care services in Sierra Leone 8 years after ceasefire. International Journal of Gynaecology and Obstetrics 2011, 114(2): 168–73.
[17] Ueno E, Adegoke AA, Masenga G, Fimbo J, Msuya SE. Skilled Birth Attendants in Tanzania: A Descriptive Study of Cadres and Emergency Obstetric Care Signal Functions Performed Maternal and Child Health J 2014, 18(4): doi: DOI 10.1007/s10995-014-1506-z.
[18] Paxton A, Bailey P, & Lobis S. The United Nations Process Indicators for emergency obstetric care: Reflections based on a decade of experience. International Journal of Gynaecology and Obstetrics 2006, 95(2): 192–208.
[19] Gabrysch, S., Zanger, P., & Campbell, O. M. R. (2012). Emergency obstetric care availability : a critical assessment of the current indicator, 17(1), 2–8. doi:10.1111/j.1365-3156.2011.02851.x.
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Author Information
  • Kilimanjaro Christian Medical University College (KCMU Co), Moshi, Tanzania

  • Insitute of Public Health, Department of Epidemiology and Biostatistics, KCMU Co, Moshi, Tanzania; Institute of Public Health, Department of Community Medicine, KCMC Hospital and KCMU Co, Moshi, Tanzania

  • Department of Obstetrics and Gynecology, KCMC Hospital and KCMU Co, Moshi, Tanzania

  • RCH Section, Ministry of Health and Social Welfare, Dar es Salaam, Tanzania

  • Insitute of Public Health, Department of Epidemiology and Biostatistics, KCMU Co, Moshi, Tanzania

  • Insitute of Public Health, Department of Epidemiology and Biostatistics, KCMU Co, Moshi, Tanzania; Institute of Public Health, Department of Community Medicine, KCMC Hospital and KCMU Co, Moshi, Tanzania

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  • APA Style

    Rahma Muhammad Bakari, Damian Jeremia Damian, Patricia Swai, Ahmad Mohamed Makuwani, Michael Johnson Mahande, et al. (2015). Assessment of Availability, Utilization and Quality of Emergency Obstetric Care in 2014 at Hai District, Northern Tanzania. Journal of Gynecology and Obstetrics, 3(3), 43-48. https://doi.org/10.11648/j.jgo.20150303.11

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    ACS Style

    Rahma Muhammad Bakari; Damian Jeremia Damian; Patricia Swai; Ahmad Mohamed Makuwani; Michael Johnson Mahande, et al. Assessment of Availability, Utilization and Quality of Emergency Obstetric Care in 2014 at Hai District, Northern Tanzania. J. Gynecol. Obstet. 2015, 3(3), 43-48. doi: 10.11648/j.jgo.20150303.11

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    AMA Style

    Rahma Muhammad Bakari, Damian Jeremia Damian, Patricia Swai, Ahmad Mohamed Makuwani, Michael Johnson Mahande, et al. Assessment of Availability, Utilization and Quality of Emergency Obstetric Care in 2014 at Hai District, Northern Tanzania. J Gynecol Obstet. 2015;3(3):43-48. doi: 10.11648/j.jgo.20150303.11

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  • @article{10.11648/j.jgo.20150303.11,
      author = {Rahma Muhammad Bakari and Damian Jeremia Damian and Patricia Swai and Ahmad Mohamed Makuwani and Michael Johnson Mahande and Sia Emmanueli Msuya},
      title = {Assessment of Availability, Utilization and Quality of Emergency Obstetric Care in 2014 at Hai District, Northern Tanzania},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {3},
      number = {3},
      pages = {43-48},
      doi = {10.11648/j.jgo.20150303.11},
      url = {https://doi.org/10.11648/j.jgo.20150303.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.jgo.20150303.11},
      abstract = {Background: Availability of emergency obstetric and newborn care (EmOC) is one of interventions to reduce maternal and newborn deaths. Maternal and newborn mortality is a public health problem in most developing countries including Tanzania. In these settings, coverage of EmOC is low especially in rural areas, with limited information on availability and use of EmOC services. Objectives: To assess the availability, utilization and quality of emergency obstetric care in Hai district, located at Kilimanjaro region, northern Tanzania. Methods: A cross-sectional survey of 12 health facilities (2 hospitals and 10 primary health care facilities) which provide delivery services in the district was conducted in May- June 2014. Modified AMDD data collection tool was used and it assessed availability of services, supplies and equipments, infrastructure and actual performance of EmOC within the past 3 months prior to the interview. Proportions were used to summarize the data. Results: The two comprehensive EmOC facilities (CEmOC) could provide all the nine required signal functions while none of the basic EmOC facilities (BEmOC) could provide the seven required signal functions. For a population of 214,454 in the district, the total number of health facilities designated to provide EmOC services exceeded the minimum required number which was 1 for CEmOC and 2 BEmOC. The proportion of births taking place in facilities was 65.3% and the met need for emergency obstetric complications was 94.5%. Population based caesarean section rate and the still birth rate were 7.4% and 1.3% respectively. Conclusion: BEmOC facilities, which are the first level of care for majority of women and newborns with complications, need to be strengthened to offer the required medical and surgical interventions to save lives. There is a need to scale-up training of health providers especially at the lower level (dispensaries and health centres) in EmOC as well as to strength supply chain system in order to contribute in attaining the national BEmOC coverage of 70% by December 2015.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Assessment of Availability, Utilization and Quality of Emergency Obstetric Care in 2014 at Hai District, Northern Tanzania
    AU  - Rahma Muhammad Bakari
    AU  - Damian Jeremia Damian
    AU  - Patricia Swai
    AU  - Ahmad Mohamed Makuwani
    AU  - Michael Johnson Mahande
    AU  - Sia Emmanueli Msuya
    Y1  - 2015/04/10
    PY  - 2015
    N1  - https://doi.org/10.11648/j.jgo.20150303.11
    DO  - 10.11648/j.jgo.20150303.11
    T2  - Journal of Gynecology and Obstetrics
    JF  - Journal of Gynecology and Obstetrics
    JO  - Journal of Gynecology and Obstetrics
    SP  - 43
    EP  - 48
    PB  - Science Publishing Group
    SN  - 2376-7820
    UR  - https://doi.org/10.11648/j.jgo.20150303.11
    AB  - Background: Availability of emergency obstetric and newborn care (EmOC) is one of interventions to reduce maternal and newborn deaths. Maternal and newborn mortality is a public health problem in most developing countries including Tanzania. In these settings, coverage of EmOC is low especially in rural areas, with limited information on availability and use of EmOC services. Objectives: To assess the availability, utilization and quality of emergency obstetric care in Hai district, located at Kilimanjaro region, northern Tanzania. Methods: A cross-sectional survey of 12 health facilities (2 hospitals and 10 primary health care facilities) which provide delivery services in the district was conducted in May- June 2014. Modified AMDD data collection tool was used and it assessed availability of services, supplies and equipments, infrastructure and actual performance of EmOC within the past 3 months prior to the interview. Proportions were used to summarize the data. Results: The two comprehensive EmOC facilities (CEmOC) could provide all the nine required signal functions while none of the basic EmOC facilities (BEmOC) could provide the seven required signal functions. For a population of 214,454 in the district, the total number of health facilities designated to provide EmOC services exceeded the minimum required number which was 1 for CEmOC and 2 BEmOC. The proportion of births taking place in facilities was 65.3% and the met need for emergency obstetric complications was 94.5%. Population based caesarean section rate and the still birth rate were 7.4% and 1.3% respectively. Conclusion: BEmOC facilities, which are the first level of care for majority of women and newborns with complications, need to be strengthened to offer the required medical and surgical interventions to save lives. There is a need to scale-up training of health providers especially at the lower level (dispensaries and health centres) in EmOC as well as to strength supply chain system in order to contribute in attaining the national BEmOC coverage of 70% by December 2015.
    VL  - 3
    IS  - 3
    ER  - 

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