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Am J Perinatol 2013; 30(09): 787-794
DOI: 10.1055/s-0032-1333409
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Assessment of Obstetric and Neonatal Health Services in Developing Country Health Facilities

Albert Manasyan
1   Centre for Infectious Disease Zambia, Lusaka, Zambia
2   Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
,
Sarah Saleem
3   Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
,
Marion Koso-Thomas
4   Perinatology and Pregnancy Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
,
Fernando Althabe
5   Department of Mother and Child Health Research, Institute of Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
,
Omrana Pasha
3   Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
,
Elwyn Chomba
1   Centre for Infectious Disease Zambia, Lusaka, Zambia
2   Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
6   Department of Pediatrics, University of Zambia, Lusaka, Zambia
,
Shivaprasad S. Goudar
7   Department of Physiology, KLE's Jawaharlal Nehru Medical College, Belgaum, India
,
Archana Patel
8   Clinical Epidemiology Unit, Indira Gandhi Government Medical College, Nagpur, India
,
Fabian Esamai
9   Department of Pediatrics, Moi University, Eldoret, Kenya
,
Ana Garces
10   IMSALUD, Francisco Marroquin University, Guatemala City, Guatemala
,
Bhala Kodkany
11   Department of Obstetrics, KLE's Jawaharlal Nehru Medical College, Belgaum, India
,
Jose Belizan
5   Department of Mother and Child Health Research, Institute of Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
,
Elizabeth M. McClure
12   Social, Statistical and Environmental Sciences, Research Triangle Institute, Durham, North Carolina
,
Richard J. Derman
13   Department of Obstetrics, Christiana Health Care, Newark, Delaware
,
Patricia Hibberd
14   Department of Pediatrics, Indiana University, Indianapolis, Indiana
,
Edward A. Liechty
15   Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts
,
K. Michael Hambidge
16   Department of Pediatrics, University of Colorado, Denver
,
Waldemar A. Carlo
1   Centre for Infectious Disease Zambia, Lusaka, Zambia
,
Pierre Buekens
17   Tulane School of Public Health and Tropical Medicine, New Orleans, LA
,
Janet Moore
12   Social, Statistical and Environmental Sciences, Research Triangle Institute, Durham, North Carolina
,
Linda L. Wright
18   Center for Research for Mothers and Children, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
,
Robert L. Goldenberg
19   Department of Obstetrics and Gynecology, Columbia University, New York, New York
,
for the EmONC Trial Group › Author Affiliations
Further Information

Publication History

07 September 2012

02 November 2012

Publication Date:
17 January 2013 (online)

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Abstract

Objective To describe the staffing and availability of medical equipment and medications and the performance of procedures at health facilities providing maternal and neonatal care at African, Asian, and Latin American sites participating in a multicenter trial to improve emergency obstetric/neonatal care in communities with high maternal and perinatal mortality.

Study Design In 2009, prior to intervention, we surveyed 136 hospitals and 228 clinics in 7 sites in Africa, Asia, and Latin America regarding staffing, availability of equipment/medications, and procedures including cesarean section.

Results The coverage of physicians and nurses/midwives was poor in Africa and Latin America. In Africa, only 20% of hospitals had full-time physicians. Only 70% of hospitals in Africa and Asia had performed cesarean sections in the last 6 months. Oxygen was unavailable in 40% of African hospitals and 17% of Asian hospitals. Blood was unavailable in 80% of African and Asian hospitals.

Conclusions Assuming that adequate facility services are necessary to improve pregnancy outcomes, it is not surprising that maternal and perinatal mortality rates in the areas surveyed are high. The data presented emphasize that to reduce mortality in these areas, resources that result in improved staffing and sufficient equipment, supplies, and medication, along with training, are required.

Keywords

emergency obstetric and neonatal care - developing countries - perinatal mortality
 

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