Federal Ministry of Health, Addis Ababa, Ethiopia.
Int J Gynaecol Obstet. 2011 Oct;115(1):101-5. doi: 10.1016/j.ijgo.2011.07.010. Epub 2011 Sep 8.
To report on the availability and quality of emergency obstetric and newborn care (EmONC) in Ethiopia.
All licensed hospitals and health centers were visited and standard questionnaires were administered. In addition, a nonrandom systematic sample was taken of recent cesarean deliveries, partographs, and maternal deaths-and these cases were systematically reviewed. Health facilities were geocoded using geographic positioning system devices.
Too few facilities provided EmONC to meet the UN standards of 5 per 500,000 population, both nationally and in all but 2 regions. Only 7% of deliveries took place in institutions of any type, and only 3% in facilities that routinely provided all the signal functions. Only 6% of women with obstetric complications were treated in any health facility, half of whom were treated in fully functional EmONC facilities. Nationwide, 0.6% of expected deliveries were by cesarean. The mortality rate for women with serious obstetric complications (case fatality rate) was 2%. The cause of death was unknown in 10% of cases, and 21% were due to indirect causes (primarily malaria, anemia, and HIV-related).
None of the indicators met UN standards. Ethiopia faces many challenges--not least geography--with regard to improving EmONC. Nevertheless, the government places high priority on improvement and has taken (and will continue to take) action to achieve Millennium Development Goals 4 and 5. This comprehensive survey serves both as a road map for planning strategies for improvement and as a baseline for measuring the impact of interventions.
报告埃塞俄比亚紧急产科和新生儿保健（EmONC）的可及性和质量。
对所有持照医院和保健中心进行了访问，并使用标准问卷进行了调查。此外，还对最近的剖宫产、产程图和产妇死亡进行了非随机系统抽样，并对这些病例进行了系统审查。使用全球定位系统设备对保健设施进行了地理编码。
全国范围内以及除两个地区以外的所有地区，提供 EmONC 的设施太少，无法达到每 50 万人口 5 个的联合国标准。只有 7%的分娩发生在任何类型的机构，只有 3%发生在常规提供所有信号功能的设施。只有 6%的产科并发症妇女在任何保健机构接受治疗，其中一半在功能齐全的 EmONC 设施接受治疗。全国范围内，预期分娩中有 0.6%是剖宫产。严重产科并发症（病死率）妇女的死亡率为 2%。10%的病例死因不明，21%是间接原因（主要是疟疾、贫血和与 HIV 相关的原因）。
没有一个指标符合联合国标准。埃塞俄比亚在改善 EmONC 方面面临许多挑战，尤其是地理方面的挑战。然而，政府高度重视改善，并已采取（并将继续采取）行动，以实现千年发展目标 4 和 5。这项全面调查既是规划改进战略的路线图，也是衡量干预措施影响的基线。
