Measuring the preparedness of health facilities to deliver emergency obstetric care in a South African district

Improving the delivery of emergency obstetric care (EmNOC) remains critical in addressing direct causes of maternal mortality. United Nations (UN) agencies have promoted standard methods for evaluating the availability of EmNOC facilities although modifications have been proposed by others. This stu...

Full description

Saved in:
Bibliographic Details
Published in:PloS one 2018-03, Vol.13 (3), p.e0194576-e0194576
Main Authors: Thwala, Siphiwe Bridget Pearl, Blaauw, Duane, Ssengooba, Freddie
Format: Article
Language:English
Subjects:
Analysis
Availability
Births
Check lists
Control
Data collection
Demographic aspects
Emergency management
Engineering and Technology
Fertility
Handbooks
Health care facilities
Health facilities
Health sciences
Health services
Hospital facilities
Hospitals
Management
Maternal mortality
Medicine and Health Sciences
Mortality
Norms
Obstetrics
People and Places
Public health
Resuscitation
Surveys
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Improving the delivery of emergency obstetric care (EmNOC) remains critical in addressing direct causes of maternal mortality. United Nations (UN) agencies have promoted standard methods for evaluating the availability of EmNOC facilities although modifications have been proposed by others. This study presents an assessment of the preparedness of public health facilities to provide EmNOC using these methods in one South African district with a persistently high maternal mortality ratio. Data collection took place in the final quarter of 2014. Cross-sectional surveys were conducted to classify the 7 hospitals and 8 community health centres (CHCs) in the district as either basic EmNOC (BEmNOC) or comprehensive EmNOC (CEmNOC) facilities using UN EmNOC signal functions. The required density of EmNOC facilities was calculated using UN norms. We also assessed the availability of EmNOC personnel, resuscitation equipment, drugs, fluids, and protocols at each facility. The workload of skilled EmNOC providers at hospitals and CHCs was compared. All 7 hospitals in the district were classified as CEmNOC facilities, but none of the 8 CHCs performed all required signal functions to be classified as BEmNOC facilities. UN norms indicated that 25 EmNOC facilities were required for the district population, 5 of which should be CEmNOCs. None of the facilities had 100% of items on the EmNOC checklists. Hospital midwives delivered an average of 36.4±14.3 deliveries each per month compared to only 7.9±3.2 for CHC midwives (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0194576