Department of Reproductive Health, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
Reprod Health. 2013 Aug 23;10:43. doi: 10.1186/1742-4755-10-43.
The goal of reducing maternal mortality can be achieved when women receive important service components at the time of their maternity care. This study attempted to assess the availability and the components of maternity services according to the perspectives of service users and providers.
A linked facility and population-based survey was conducted over three months (January to March 2012) in North Gondar Zone. Twelve kebeles (clusters) were selected randomly from six districts to identify maternity clients cared for by skilled providers. Then 12 health centers and 3 hospitals utilized by the corresponding cluster population were selected for facility survey. Interview with facility managers/heads, providers and clients and observations were used for data collection. Data were entered using Epi Info and were exported to SPSS software for analysis.
Antenatal and delivery care were available in most of the visited facilities. However, the majority of them were not fully functioning for EmOC according to their level. Signal functions including administration of anticonvulsants and assisted vaginal delivery were missing in seven and five of the 12 health centers, respectively. Only one hospital met the criteria for comprehensive emergency obstetric care (performed cesarean section). Only 24% of the providers used partograph consistently. About 538 (32.3%) and 231 (13.8%) of the women received antenatal and delivery care from skilled providers, respectively. Most of the services were at health centers by nurses/midwives. At the time of the antenatal care, women received the important components of the services (percentage of users in bracket) like blood pressure checkup (79%), urine testing (35%), tetanus immunization (45%), iron supplementation (64%), birth preparedness counseling (51%) and HIV testing (71%). During delivery, 80% had their blood pressure measured, 78% were informed on labor progress, 89% had auscultation of fetal heartbeat, 80% took drugs to prevent bleeding and 78% had counseling on early & exclusive breast-feeding.
Antenatal and delivery care were available in most of the visited facilities. However, important components of both the routine and emergency maternity care services were incomplete. Improving the functional capacity of health facilities for the delivery of routine maternity and EmOC services are needed.
当妇女在接受产科护理时获得重要的服务内容时，就可以实现降低孕产妇死亡率的目标。本研究试图根据服务使用者和提供者的观点评估产科服务的可用性和组成部分。
在 2012 年 1 月至 3 月的三个月期间，在北贡达尔地区进行了一项设施与人群相结合的调查。从六个区中随机选择 12 个 kebeles（集群），以确定由熟练提供者照顾的产妇客户。然后，选择相应集群人群使用的 12 个卫生中心和 3 家医院进行设施调查。使用与设施经理/负责人、提供者和客户进行访谈以及观察来收集数据。使用 Epi Info 输入数据，并将其导出到 SPSS 软件进行分析。
大多数访问的设施都提供了产前和分娩护理。然而，根据其级别，它们大多数都没有完全发挥紧急产科护理的功能。在 12 个卫生中心中，有 7 个没有提供抗惊厥药物的管理，5 个没有提供辅助阴道分娩。只有一家医院符合全面紧急产科护理的标准（进行剖宫产）。只有 24%的提供者始终如一地使用产程图。分别有 538 名（32.3%）和 231 名（13.8%）妇女接受了熟练提供者的产前和分娩护理。大多数服务都是由护士/助产士在卫生中心提供的。在产前保健期间，妇女接受了服务的重要组成部分（括号内为用户比例），如血压检查（79%）、尿液检查（35%）、破伤风免疫（45%）、铁补充剂（64%）、生育准备咨询（51%）和艾滋病毒检测（71%）。在分娩期间，80%的妇女测量了血压，78%的妇女被告知分娩进展，89%的妇女听诊了胎儿心跳，80%的妇女服用了预防出血的药物，78%的妇女接受了早期和纯母乳喂养咨询。
大多数访问的设施都提供了产前和分娩护理。然而，常规和紧急产科护理服务的重要组成部分都不完整。需要提高卫生设施提供常规产科和紧急产科护理服务的功能能力。
