Al Serouri Abdul Wahed, Al Rabee Arwa, Bin Afif Mohammed, Al Rukeimi Abdullah
Community Health Department, Faculty of Medicine and Health Sciences, Sana'a University, Yemen.
Int J Gynaecol Obstet. 2009 Apr;105(1):86-91. doi: 10.1016/j.ijgo.2008.12.020. Epub 2009 Feb 10.
The Yemen is a signatory of the Millennium Development Goals (MDGs) and one of 10 countries chosen for the UN Millennium Project. However, recent MDG progress reviews show that it is unlikely that the maternal health goal will be reached by 2015 and Yemen still has an unacceptably high maternal mortality of 365 per 100000 live births. Because 82% of deaths happen intrapartum, the purpose of this needs assessment was to identify and prioritize constraints in delivery of emergency obstetric care (EmOC).
Four district hospitals and 16 health centers in 8 districts were assessed for functional capacity in terms of infrastructure; availability of essential equipment and drugs; EmOC technical competency and training needs; and Health Management Information System.
We found poor obstetric services in terms of structure (staffing pattern, equipment, and supplies) and process (knowledge and management skills).
The data argue for strengthening the 4 interlinked health system elements-human resources, and access to, use, and quality of services. The Government must address each of these elements to meet the Safe Motherhood MDG.
也门是《千年发展目标》（MDGs）的签署国，也是联合国千年项目选定的10个国家之一。然而，最近的千年发展目标进展评估表明，到2015年不太可能实现孕产妇健康目标，也门的孕产妇死亡率仍然高得令人无法接受，每10万例活产中有365例死亡。由于82%的死亡发生在分娩期间，本次需求评估的目的是确定紧急产科护理（EmOC）提供过程中的制约因素并确定其优先顺序。
对8个地区的4家区级医院和16个卫生中心进行了评估，内容包括基础设施方面的功能能力；基本设备和药品的可用性；紧急产科护理技术能力和培训需求；以及卫生管理信息系统。
我们发现，在结构（人员配置模式、设备和用品）和流程（知识和管理技能）方面，产科服务较差。
数据表明需要加强4个相互关联的卫生系统要素——人力资源以及服务的可及性、利用情况和质量。政府必须解决这些要素中的每一个问题，以实现安全孕产千年发展目标。
