Abstract:
The functionality of emergency obstetric and newborn services (EmONC) is very important in the management of obstetric complications and reduction of maternal mortality. A descriptive and qualitative study was conducted in the Kadjebi District to assess the functionality of EmONC, and identify factors that affected it. Six facilities in the district a mission and public that provided obstetric services were studied. The EmONC Needs Assessment module 5, supervision checklist for hospitals and clinics was used to assess functionality. The following signal functions: ability to administer parenteral antibiotics, parenteral oxytocic drugs, parenteral anticonvulsants for pre-eclampsia and eclampsia, perform manual removal of placenta, retained products of conception, resuscitation of newborn and assisted vaginal delivery were used to identify a facility as providing basic essential obstetric care services. A comprehensive emergency obstetric care facility was identified as one able to perform all the signal functions for a basic essential obstetric care facility and in addition be able to perform caesarean section surgery and blood transfusion. An interview guide was designed and used to conduct key informant interviews with selected heads of facilities where obstetric services were provided. The key informant interviews were conducted to determine factors associated with functionality of services. Out of the 6 health facilities in the district, only one provided comprehensive emergency obstetric and newborn care services while the rest, provided basic obstetric care services however, none could perform all the signal functions needed to be identified as a facility providing basic essential obstetric care services. The function performed by all these facilities was newborn resuscitation and oxytoxic administration. None of them performed assisted vaginal deliveries. The factors found to be associated with functionality of emergency obstetric and newborn care services were lack of trained personnel due to inadequate number of midwives, managerial, supply and policy issues.
To improve availability of essential obstetric services in the district these recommendations are being proposed to the District Director of Health Services. There should be continuing in-service training for all staff to upgrade their skills especially on lifesaving skills. The need for collaboration with stakeholders for regular supply of basic equipment, drugs for efficient service delivery.
