Cham Mamady, Sundby Johanne, Vangen Siri
Institute of General Practice and Community Medicine, University of Oslo, Norway.
Reprod Health. 2009 Apr 14;6:5. doi: 10.1186/1742-4755-6-5.
Reduction of maternal mortality ratio by two-thirds by 2015 is an international development goal with unrestricted access to high quality emergency obstetric care services promoted towards the attainment of that goal. The objective of this qualitative study was to assess the availability and quality of emergency obstetric care services in Gambia's main referral hospital.
From weekend admissions a group of 30 women treated for different acute obstetric conditions including five main diagnostic groups: hemorrhage, hypertensive disorders, dystocia, sepsis and anemia were purposively selected. In-depth interviews with the women were carried out at their homes within two weeks of discharge.
Substantial difficulties in obtaining emergency obstetric care were uncovered. Health system inadequacies including lack of blood for transfusion, shortage of essential medicines especially antihypertensive drugs considerably hindered timely and adequate treatment for obstetric emergencies. Such inadequacies also inflated the treatment costs to between 5 and 18 times more than standard fees. Blood transfusion and hypertensive treatment were associated with the largest costs.
The deficiencies in the availability of life-saving interventions identified are manifestations of inadequate funding for maternal health services. Substantial increase in funding for maternal health services is therefore warranted towards effective implementation of emergency obstetric care package in The Gambia.
到2015年将孕产妇死亡率降低三分之二是一项国际发展目标，为实现该目标，提倡不受限制地获得高质量的紧急产科护理服务。这项定性研究的目的是评估冈比亚主要转诊医院紧急产科护理服务的可及性和质量。
从周末入院的患者中，有目的地挑选出30名因不同急性产科疾病接受治疗的妇女，这些疾病包括五个主要诊断类别：出血、高血压疾病、难产、败血症和贫血。在出院两周内，对这些妇女进行了家访并进行深入访谈。
研究发现，在获得紧急产科护理方面存在重大困难。卫生系统的不足，包括缺乏输血用血、基本药物尤其是抗高血压药物短缺，严重阻碍了对产科急症的及时和充分治疗。这些不足还使治疗费用比标准费用高出5至18倍。输血和高血压治疗的费用最高。
所发现的救命干预措施可及性方面的不足，是孕产妇保健服务资金不足的表现。因此，有必要大幅增加孕产妇保健服务的资金，以有效实施冈比亚的紧急产科护理方案。
