Urassa David P, Carlstedt Anders, Nyström Lennarth, Massawe Siriel N, Lindmark Gunilla
Department of Community Health/Obstetrics and Gynaecology, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania.
Afr J Reprod Health. 2005 Dec;9(3):100-11.
To assess coverage and quality of essential obstetric care (EOC) and the appropriateness of using processindicators, a 3-month follow-up study was done in Rufiji district, Tanzania, involving 2 hospitals, 4 health centres, 10 large dispensaries and 10 randomly selected small dispensaries. Data collection was done on process indicators as suggested by UNICEF/WHO/UNFPA (UN) and 'unmet obstetric need (UON) for major obstetric intervention (MOI)'. With standard values in (brackets), the district had two comprehensive EOC facilities, births in EOC amounted to 62% (15%), met need for EOC was 76% (100%), caesarean section (C/S) rate 4.1% (> 5%), hospital case fatality rate (CFR) 1.0% (< 1%) and successful obstetric referrals 46% (100%). MOI for absolute maternal indication in the district was 2.6% (1-2%). All four maternal deaths occurred due to transport failures. The process indicators gave contradictory impressions on the coverage and quality of care and failed to link to the outcome of delivery complications in the study.
为评估基本产科护理（EOC）的覆盖范围和质量以及使用过程指标的适宜性，在坦桑尼亚鲁菲吉区开展了一项为期3个月的随访研究，涉及2家医院、4个健康中心、10家大型诊所和10家随机选取的小型诊所。按照联合国儿童基金会/世界卫生组织/联合国人口基金（UN）建议的过程指标以及“重大产科干预（MOI）的未满足产科需求（UON）”进行数据收集。（括号内为标准值）该地区有两家具备全面EOC服务的机构，EOC机构内的分娩率为62%（15%），满足EOC需求的比例为76%（100%），剖宫产（C/S）率为4.1%（>5%），医院病死率（CFR）为1.0%（<1%），成功的产科转诊率为46%（100%）。该地区因绝对母体指征进行MOI的比例为2.6%（1 - 2%）。所有4例孕产妇死亡均因转运失败所致。过程指标在护理的覆盖范围和质量方面给出了相互矛盾的印象，且在该研究中未能与分娩并发症的结局相关联。
