Faculty of Medical Sciences, Universitair Medisch Centrum Groningen, University of Groningen, Groningen, The Netherlands.
Maternity Department, Butajira General Hospital, Butajira, Ethiopia.
BMJ Open. 2017 Nov 8;7(11):e018459. doi: 10.1136/bmjopen-2017-018459.
To assess the provision of basic emergency obstetric and newborn care (BEmONC), knowledge of high-risk pregnancies and referral capacity at health centres in Southern Ethiopia.
A facility-based survey, using an abbreviated version of the Averting Maternal Death and Disability needs assessment tool for emergency obstetric and newborn care. Modules included infrastructure, staffing, number of deliveries, maternal and perinatal mortality, BEmONC signal functions, referral capacity and knowledge of risk factors in pregnancy.
Primary healthcare centres providing delivery services in the Eastern Gurage Zone, a predominantly rural area in Southern Ethiopia.
All 20 health centres in the study area were selected for the assessment. One was excluded, as no delivery services had been provided in the 12 months prior to the study.
Three out of 19 health centres met the government's staffing norm. In the 12 months prior to the survey, 10 004 ([Formula: see text]) deliveries were attended to at the health centres, but none had provided all seven BEmONC signal functions in the three months prior to the survey ([Formula: see text]). Eight maternal and 32 perinatal deaths occurred. Most health centres had performed administration of parenteral uterotonics (17/89.5%), manual removal of placenta (17/89.5%) and neonatal resuscitation (17/89.5%), while few had performed assisted vaginal delivery (3/15.8%) or administration of parenteral anticonvulsants (1/5.3%). Reasons mentioned for non-performance were lack of patients with appropriate indications, lack of training and supply problems. Health workers mentioned on average 3.9±1.4 of 11 risk factors for adverse pregnancy outcomes. Five ambulances were available in the zone.
BEmONC provision is not guaranteed to women giving birth in health centres in Southern Ethiopia. Since the government aims to increase facility deliveries, investments in capacity at health centres are urgently needed.
评估埃塞俄比亚南部卫生中心提供基本产科和新生儿急救护理（BEmONC）、高危妊娠知识和转诊能力的情况。
一项基于设施的调查，使用简化的避免孕产妇死亡和残疾需求评估工具来评估产科和新生儿急救护理。模块包括基础设施、人员配备、分娩数量、孕产妇和围产期死亡率、BEmONC 信号功能、转诊能力和妊娠风险因素知识。
在埃塞俄比亚南部的东古拉格地区提供分娩服务的初级保健中心，该地区主要是农村地区。
研究区域内的所有 20 个卫生中心都被选进行评估。其中一个被排除在外，因为在研究前的 12 个月内没有提供分娩服务。
在 19 个卫生中心中，有 3 个符合政府的人员配备标准。在调查前的 12 个月内，有 10004 名产妇在卫生中心分娩，但在调查前的 3 个月内，没有一个中心提供了所有 7 项 BEmONC 信号功能([Formula: see text])。发生了 8 例孕产妇死亡和 32 例围产期死亡。大多数卫生中心都进行了静脉注射宫缩素的管理（17/89.5%）、人工胎盘剥离（17/89.5%）和新生儿复苏（17/89.5%），而很少有卫生中心进行了辅助阴道分娩（3/15.8%）或静脉注射抗惊厥药物（1/5.3%）。未进行这些操作的原因是缺乏具有适当指征的患者、缺乏培训和供应问题。卫生工作者平均提到了 11 个不良妊娠结局风险因素中的 3.9±1.4 个。该地区有 5 辆救护车。
在埃塞俄比亚南部，妇女在卫生中心分娩并不能保证得到基本产科和新生儿急救护理。由于政府旨在增加医疗机构分娩数量，因此急需对卫生中心的能力进行投资。
