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

Rahma Muhammad Bakari; Damian Jeremia Damian; Patricia Swai; Ahmad Mohamed Makuwani; Michael Johnson Mahande; Sia Emmanueli Msuya

doi:doi:10.11648/j.jgo.20150303.11

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

Rahma Muhammad Bakari, Damian Jeremia Damian, Patricia Swai, Ahmad Mohamed Makuwani, Michael Johnson Mahande, Sia Emmanueli Msuya

Published in Journal of Gynecology and Obstetrics (Volume 3, Issue 3)

Received: 20 March 2015 Accepted: 1 April 2015 Published: 10 April 2015

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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.

Published in	Journal of Gynecology and Obstetrics (Volume 3, Issue 3)
DOI	10.11648/j.jgo.20150303.11
Page(s)	43-48
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Emergency Obstetric Care, UN Process Indicators, Maternal Mortality, Tanzania

References

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[4]	National Bureau of Statistics (NBS) and ORC Macro: Tanzania Demographic and Health Survey 2004-05. Dar es Salaam, Tanzania 2005.
[5]	MOHSW (2008). The National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania: 2008-2015. One Plan. RCHS, Directorate of Preventive Services, United Republic of Tanzania, Dar es Salaam, April, 2008.
[6]	National Bureau of Statistics (NBS) and ICF Macro: Tanzania Demographic and Health Survey, 2010. Dar es Salaam, Tanzania 2011.
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[8]	WHO. (2004).Making pregnancy safer: the critical role of the skilled attendant. A joint statement by WHO, ICM and FIGO. Geneva, Switzerland: WHO press
[9]	MOHSW (2014). Mid Term Review of the National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania: 2008-2015. One Plan. RCHS, Directorate of Preventive Services, United Republic of Tanzania, Dar es Salaam, April, 2014.
[10]	MOHSW (2013). Tanzania Service Availability and Readiness Assessment (SARA) 2012: Final Report. Dar es Salaam, Tanzania, March 2013.
[11]	MOHSW (2014). The National Road Map Strategic Plan to Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania: 2008-2015. Sharpened One Plan. RCHS, Directorate of Preventive Services, United Republic of Tanzania, Dar es Salaam, April, 2014.
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[15]	Ameh C, Msuya S, Hofman J, Raven J, Mathai M, et al. (2012) Status of Emergency Obstetric Care in Six Developing Countries Five Years before the MDG Targets for Maternal and Newborn Health. PLoS ONE 2012, 7(12): e49938. doi:10.1371/journal.pone.0049938
[16]	Oyerinde K, Harding Y, Amara P, Kanu R, Shoo R, et al. et al. The status of maternal and newborn care services in Sierra Leone 8 years after ceasefire. International Journal of Gynaecology and Obstetrics 2011, 114(2): 168–73.
[17]	Ueno E, Adegoke AA, Masenga G, Fimbo J, Msuya SE. Skilled Birth Attendants in Tanzania: A Descriptive Study of Cadres and Emergency Obstetric Care Signal Functions Performed Maternal and Child Health J 2014, 18(4): doi: DOI 10.1007/s10995-014-1506-z.
[18]	Paxton A, Bailey P, & Lobis S. The United Nations Process Indicators for emergency obstetric care: Reflections based on a decade of experience. International Journal of Gynaecology and Obstetrics 2006, 95(2): 192–208.
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APA Style

Rahma Muhammad Bakari, Damian Jeremia Damian, Patricia Swai, Ahmad Mohamed Makuwani, Michael Johnson Mahande, et al. (2015). Assessment of Availability, Utilization and Quality of Emergency Obstetric Care in 2014 at Hai District, Northern Tanzania. Journal of Gynecology and Obstetrics, 3(3), 43-48. https://doi.org/10.11648/j.jgo.20150303.11

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ACS Style

Rahma Muhammad Bakari; Damian Jeremia Damian; Patricia Swai; Ahmad Mohamed Makuwani; Michael Johnson Mahande, et al. Assessment of Availability, Utilization and Quality of Emergency Obstetric Care in 2014 at Hai District, Northern Tanzania. J. Gynecol. Obstet. 2015, 3(3), 43-48. doi: 10.11648/j.jgo.20150303.11

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AMA Style

Rahma Muhammad Bakari, Damian Jeremia Damian, Patricia Swai, Ahmad Mohamed Makuwani, Michael Johnson Mahande, et al. Assessment of Availability, Utilization and Quality of Emergency Obstetric Care in 2014 at Hai District, Northern Tanzania. J Gynecol Obstet. 2015;3(3):43-48. doi: 10.11648/j.jgo.20150303.11

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@article{10.11648/j.jgo.20150303.11,
  author = {Rahma Muhammad Bakari and Damian Jeremia Damian and Patricia Swai and Ahmad Mohamed Makuwani and Michael Johnson Mahande and Sia Emmanueli Msuya},
  title = {Assessment of Availability, Utilization and Quality of Emergency Obstetric Care in 2014 at Hai District, Northern Tanzania},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {3},
  number = {3},
  pages = {43-48},
  doi = {10.11648/j.jgo.20150303.11},
  url = {https://doi.org/10.11648/j.jgo.20150303.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20150303.11},
  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.},
 year = {2015}
}

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TY  - JOUR
T1  - Assessment of Availability, Utilization and Quality of Emergency Obstetric Care in 2014 at Hai District, Northern Tanzania
AU  - Rahma Muhammad Bakari
AU  - Damian Jeremia Damian
AU  - Patricia Swai
AU  - Ahmad Mohamed Makuwani
AU  - Michael Johnson Mahande
AU  - Sia Emmanueli Msuya
Y1  - 2015/04/10
PY  - 2015
N1  - https://doi.org/10.11648/j.jgo.20150303.11
DO  - 10.11648/j.jgo.20150303.11
T2  - Journal of Gynecology and Obstetrics
JF  - Journal of Gynecology and Obstetrics
JO  - Journal of Gynecology and Obstetrics
SP  - 43
EP  - 48
PB  - Science Publishing Group
SN  - 2376-7820
UR  - https://doi.org/10.11648/j.jgo.20150303.11
AB  - 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.
VL  - 3
IS  - 3
ER  -

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Author Information

Rahma Muhammad Bakari

Kilimanjaro Christian Medical University College (KCMU Co), Moshi, Tanzania
Damian Jeremia Damian

Insitute of Public Health, Department of Epidemiology and Biostatistics, KCMU Co, Moshi, Tanzania
Patricia Swai

Department of Obstetrics and Gynecology, KCMC Hospital and KCMU Co, Moshi, Tanzania
Ahmad Mohamed Makuwani

RCH Section, Ministry of Health and Social Welfare, Dar es Salaam, Tanzania
Michael Johnson Mahande

Insitute of Public Health, Department of Epidemiology and Biostatistics, KCMU Co, Moshi, Tanzania
Sia Emmanueli Msuya

Insitute of Public Health, Department of Epidemiology and Biostatistics, KCMU Co, Moshi, Tanzania

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Plain Text BibTeX RIS

APA Style

Rahma Muhammad Bakari, Damian Jeremia Damian, Patricia Swai, Ahmad Mohamed Makuwani, Michael Johnson Mahande, et al. (2015). Assessment of Availability, Utilization and Quality of Emergency Obstetric Care in 2014 at Hai District, Northern Tanzania. Journal of Gynecology and Obstetrics, 3(3), 43-48. https://doi.org/10.11648/j.jgo.20150303.11

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ACS Style

Rahma Muhammad Bakari; Damian Jeremia Damian; Patricia Swai; Ahmad Mohamed Makuwani; Michael Johnson Mahande, et al. Assessment of Availability, Utilization and Quality of Emergency Obstetric Care in 2014 at Hai District, Northern Tanzania. J. Gynecol. Obstet. 2015, 3(3), 43-48. doi: 10.11648/j.jgo.20150303.11

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AMA Style

Rahma Muhammad Bakari, Damian Jeremia Damian, Patricia Swai, Ahmad Mohamed Makuwani, Michael Johnson Mahande, et al. Assessment of Availability, Utilization and Quality of Emergency Obstetric Care in 2014 at Hai District, Northern Tanzania. J Gynecol Obstet. 2015;3(3):43-48. doi: 10.11648/j.jgo.20150303.11

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@article{10.11648/j.jgo.20150303.11,
  author = {Rahma Muhammad Bakari and Damian Jeremia Damian and Patricia Swai and Ahmad Mohamed Makuwani and Michael Johnson Mahande and Sia Emmanueli Msuya},
  title = {Assessment of Availability, Utilization and Quality of Emergency Obstetric Care in 2014 at Hai District, Northern Tanzania},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {3},
  number = {3},
  pages = {43-48},
  doi = {10.11648/j.jgo.20150303.11},
  url = {https://doi.org/10.11648/j.jgo.20150303.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20150303.11},
  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.},
 year = {2015}
}

Copy | Download

TY  - JOUR
T1  - Assessment of Availability, Utilization and Quality of Emergency Obstetric Care in 2014 at Hai District, Northern Tanzania
AU  - Rahma Muhammad Bakari
AU  - Damian Jeremia Damian
AU  - Patricia Swai
AU  - Ahmad Mohamed Makuwani
AU  - Michael Johnson Mahande
AU  - Sia Emmanueli Msuya
Y1  - 2015/04/10
PY  - 2015
N1  - https://doi.org/10.11648/j.jgo.20150303.11
DO  - 10.11648/j.jgo.20150303.11
T2  - Journal of Gynecology and Obstetrics
JF  - Journal of Gynecology and Obstetrics
JO  - Journal of Gynecology and Obstetrics
SP  - 43
EP  - 48
PB  - Science Publishing Group
SN  - 2376-7820
UR  - https://doi.org/10.11648/j.jgo.20150303.11
AB  - 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.
VL  - 3
IS  - 3
ER  -

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