Availability, Utilisation and Quality of Basic and Comprehensive Emergency Obstetric Care Services in Malawi

Kongnyuy, Eugene J; Hofman, Jan; Mlava, Grace; Mhango, Chisale; Broek, Nynke van den

doi:10.1007/s10995-008-0380-y

Cited by 79 publications

(103 citation statements)

References 14 publications

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“…Accordingly, our results have demonstrated an impressive density of obstetric care facilities of 60 per 500,000 population. This coverage is higher than the 8.6-13/500,000 population that has been previously reported in other developing countries such as Bangladesh, Malawi and Ghana [8][9][10]. Moreover, in two thirds of the regions, obstetric care facilities were located within the two-hour threshold to a referral point which can allow timely access to advanced EmONC services using the most accessible means of transport during a dry season.…”

Section: Discussionmentioning

confidence: 71%

Availability, Coverage and Geographical Distribution of Emergency Obstetric and Neonatal Care Services in Tanzania Mainland

Muganyizi¹

2017

JGO

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Abstract:In order to assess the availability of Emergency Obstetric and Neonatal Care (EmONC) services in Tanzania Mainland, a Cross-sectional survey of a National sample of obstetric care facilities was conducted in 2015. We adapted the Averting Maternal Deaths and Disabilities (AMDD) tool and did spatial mapping using a calibrated Global Positioning System (GPS) Essential Software for Android and Arc Geographical Information System (GIS) software. Data were analysed using STATA, SPSS and Excel computer programs. Ethical approval was granted by the National Institute for Medical Research and the Ministry of Health, Community Development, Gender, Elderly and Children. We identified 5207 obstetric care facilities which is equivalent to 59.7 facilities per 500,000 population. We surveyed 2405 (46.2%) facilities of which 251 (10.4%) had provided all the 7 Basic Emergency Obstetric and Neonatal Care (BEmONC) in past 3 months. Among these, 130 had provided Comprehensive Emergency Obstetric and Neonatal Care (CEmONC). The UN benchmarks for BEmONC and CEmONC facility densities were attained or exceeded by 40% and 76% in all 25 regions respectively. EmONC facilities were dominated by hospitals and were clustered in cities and townships. In conclusions, the distribution of EmONC facilities in Tanzania Mainland is suboptimal in more than half of regions with clustering around cities and townships.

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Section: Discussionmentioning

confidence: 71%

Availability, Coverage and Geographical Distribution of Emergency Obstetric and Neonatal Care Services in Tanzania Mainland

Muganyizi¹

2017

JGO

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“…The geographical distribution of the facilities was good but the quality of services offered was poor especially at the BEmOC facilities. Almost all researchers from sub Saharan Africa have also shown this disparity where CEmOC are functioning while BEmOC facilities consistently offer a range of 1-3 signal functions [14][15][16][17][18]. Ameh et al (2012) showed that only 2-6% of BEmOC facilities were fully functional while Oyerinde et al (2011) observed that less than 40% of facilities could offer parenteral anticonvulsants or manual removal of placenta [15,16].…”

Section: Discussionmentioning

confidence: 99%

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

Bakari¹

2015

JGO

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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.

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“…Supervision is an essential element in the improvement of provider performance because it facilitates the use of guidelines and service standards [19]. It was observed that the majority of midwives attained their qualifications over five years ago.…”

Section: Supervision and Guidelinesmentioning

confidence: 99%

Assessment of quality of postnatal care services offered to mothers in Dedza district, Malawi

Chimtembo¹,

Maluwa²,

Chimwaza³

et al. 2013

OJN

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This study was conducted to assess quality of postnatal care that midwives provide to women seeking postnatal services in health facilities in Dedza district, the central region of Malawi. The study design was descriptive cross sectional and utilized quantitative data collection and analysis method to determine structural, process and outcome components of postnatal care in two facilities that offer emergency obstetric and neonatal care and five that offer basic emergency obstetric and neonatal care. All 60 midwives who were providing postnatal care during the time of study in the district were interviewed using a structured questionnaire. In addition, the midwives actual practice was observed and compared to a standard checklist on postnatal care practice which was developed by the Malawi Ministry of Health. Data were analyzed using SPSS version 16.0. Results show that structure for providing postnatal counseling services was inappropriate and inadequate. Furthermore, the contents of postnatal services were below reproductive health standards because the clients were neither monitored nor examined physically on discharge. On average, all the seven facilities scored 48% on postnatal services rendered which is far below the recommended 80% according to the Reproductive Health Standards. There is a need to provide basic infrastructure in all the basic emergency obstetric and neonatal care facilities. In addition, refresher training courses for midwives in maternal and neonatal health with emphasis on postnatal care are recommended. There is also a need to restructure the maternal and neonatal health departments in the facilities so that the postnatal care units become standalone priority sites to improve the quality of the postnatal care services rendered.

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Availability, Utilisation and Quality of Basic and Comprehensive Emergency Obstetric Care Services in Malawi

Cited by 79 publications

References 14 publications

Availability, Coverage and Geographical Distribution of Emergency Obstetric and Neonatal Care Services in Tanzania Mainland

Availability, Coverage and Geographical Distribution of Emergency Obstetric and Neonatal Care Services in Tanzania Mainland

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

Assessment of quality of postnatal care services offered to mothers in Dedza district, Malawi

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