Availability of comprehensive emergency obstetric and neonatal care in developing regions in Ethiopia: lessons learned from the USAID transform health activity

Abstract

Background In collaboration with its partners, the Ethiopian government has been implementing standard Emergency Obstetric and Neonatal Care Services (CEmONC) since 2010. However, limited studies documented the lessons learned from such programs on the availability of CEmONC signal functions. This study investigated the availability of CEmONC signal functions and described lessons learned from Transform Health support in Developing Regional State in Ethiopia. Method At baseline, we conducted a cross-sectional study covering 15 public hospitals in four developing regions of Ethiopia (Somali, Afar, Beneshangul Gumz, and Gambella). Then, clinical mentorship was introduced in ten selected hospitals. This was followed by reviewing the clinical mentorship program report implemented in all regions. We used the tool adapted from an Averting Maternal Death and Disability tools to collect data through face-to-face interviews. We also reviewed maternal and neonatal records. We then descriptively analyzed the data and presented the findings using text, tables, and graphs. Result At baseline, six out of the 15 hospitals performed all the nine CEmONC signal functions, and one-third of the signal functions were performed in all hospitals. Cesarean Section service was available in eleven hospitals, while blood transfusion was available in ten hospitals. The least performed signal functions were blood transfusion, Cesarean Section, manual removal of placenta, removal of retained product of conceptus, and parenteral anticonvulsants. After implementing the clinical mentorship program, all CEmONC signal functions were available in all hospitals selected for the mentorship program except for Abala Hospital; the number of Cesarean Sections increased by 7.25% at the last quarter of 2021compared to the third quarter of 20,219; and the number of women referred for blood transfusions and further management of obstetric complications decreased by 96.67% at the last quarter of 2021 compared to the third quarter of 20,219. However, the number of women with post-cesarean Section surgical site infection, obstetric complications, facility maternal deaths, neonatal deaths, and stillbirths have not been changed. Conclusion The availability of CEmONC signal functions in the supported hospitals did not change the occurrence of maternal death and stillbirth. This indicates the need for investigating underlying and proximal factors that contributed to maternal death and stillbirth in the Developing Regional State of Ethiopia. In addition, there is also the need to assess the quality of the CEmONC services in the supported hospitals, institutionalize reviews, surveillance, and response mechanism for maternal and perinatal or neonatal deaths and near misses.

Service availability and readiness to provide comprehensive emergency obstetric and newborn care services in post-conflict at North Wollo Zone hospitals, Northeast Ethiopia: mixed survey

“…The difference might be due to the study period. This study also showed that 66% of hospitals performed blood transfusions which was comparable with the study finding in Ethiopian developing regions, 66.6% [ 27 ]. Whereas the finding of this study was lower than the national Ethiopian service availability and readiness report 82% [ 21 ].…”

“…In this study, cesarean section was performed in 50% of hospitals, which was lower than the national Ethiopian service availability and readiness report of 86% [ 21 ] and study finding in Ethiopian developing regions [ 27 ]. The difference might be due to the study period.…”

Simulation training on respectful emergency obstetric and neonatal care in north-western Madagascar: a mixed-methods evaluation of an innovative training program

“…After the training was initially planned, however, it had to be radically revised in order to adapt to the limitations created by the onset of the global COVID-19 pandemic in 2020. The most obvious challenge was that the Swiss partners could not travel to Madagascar to deliver the training [ 1 , 17 , 25 , 26 ]. Other challenges included changing institutional priorities among the partners (as they pivoted to addressing COVID-19) and COVID-19-related supply chain interruptions [ 27 ].…”

Maternal satisfaction with emergency obstetric and newborn care services in Ethiopia and the associated factors: A systematic review and meta-analysis

“…EmONC services are a set of key obstetric services or signal functions provided for pregnant women and newborns against fatal complications, such as bleeding, infection, prolonged or obstructed labor, eclampsia, and asphyxia. 1,5 Emergency care is recognized as an essential and effective component of obstetric services. 6,7 Since 2008, the Ethiopian government has been providing standard EmONC in all health facilities.…”

“…Emergency obstetric and newborn care (EmONC; basic versus comprehensive) refers to caring for women and newborns during pregnancy, delivery, and postpartum to prevent serious complications or death. [1][2][3][4] The World Health Organization (WHO) estimates that, globally, approximately 15% of expected births develop life-threatening complications during pregnancy, delivery, or at the Maternal satisfaction with emergency obstetric and newborn care services in Ethiopia and the associated factors: A systematic review and meta-analysis postpartum period. EmONC services are a set of key obstetric services or signal functions provided for pregnant women and newborns against fatal complications, such as bleeding, infection, prolonged or obstructed labor, eclampsia, and asphyxia.…”