Nirupam S, Yuster E A
United Nations Children's Fund, Gandhinagar Field Office, Plot No. 382, Sector 22, Gandhinagar 382 022 Gujarat, India.
United Nations Children's Fund, Health Section India Country Office, New Delhi, India.
Int J Gynaecol Obstet. 1995 Oct;50 Suppl 2:S79-S88. doi: 10.1016/0020-7292(95)02492-U.
To reduce maternal deaths substantially, the facilities for Emergency Obstetric Care (EOC) must exist, be accessible, be utilized by complicated cases and be successful. Accordingly, a new set of indicators, viz., number of functional EOC facilities, geographic bed distribution within a district, proportion of expected births and expected complications managed at these units, and case fatality rate for complicated cases, were assessed in ten districts drawn from ten major states of India. The paper discusses the findings and some of the problems of data collection and interpretation. In general, maldistribution of beds within the district, low levels of cesarean section rates and, sometimes, high case fatality point to a need for an improvement in availability, distribution and quality of EOC. Similarly, low institutional birth rate and much lower than expected number of complications reaching the facilities point to the need for encouraging families to use them. Changes in these indicators over time will help gauge improvements in provision and utilization of EOC. The study findings and methodology are serving as an important element for developing a monitoring system for EOC under Safe Motherhood in India.
为大幅降低孕产妇死亡人数，必须具备、可及、能被复杂病例利用且能成功运作的紧急产科护理（EOC）设施。因此，在从印度十个主要邦抽取的十个地区，对一套新的指标进行了评估，即正常运作的EOC设施数量、一个地区内床位的地理分布、这些机构处理的预期分娩数和预期并发症数的比例，以及复杂病例的病死率。本文讨论了研究结果以及数据收集和解读方面的一些问题。总体而言，地区内床位分布不均、剖宫产率较低，有时病死率较高，这表明需要改善EOC的可及性、分布和质量。同样，机构分娩率较低，且到达这些机构的并发症数量远低于预期，这表明需要鼓励家庭使用这些设施。这些指标随时间的变化将有助于评估EOC提供和利用情况的改善。该研究结果和方法正成为印度安全孕产项下EOC监测系统发展的一个重要要素。
