Bunde Elizabeth, Herrera Elena, Chanthala Lathtana, Posner Jessica, Sohkivong Douangphone
John Snow, Inc., Vientiane, Lao People's Democratic Republic.
John Snow, Inc., Washington, District of Columbia, United States of America.
PLoS One. 2025 Sep 11;20(9):e0331659. doi: 10.1371/journal.pone.0331659. eCollection 2025.
Global maternal mortality rates have declined significantly over the past two decades, including an 80% reduction in Laos since 2000. Effective management of obstetric complications - a major contributor to maternal deaths - requires well-staffed facilities equipped with essential supplies, medicines, and infrastructure. Despite progress, Laos still faces gaps in service availability and readiness limiting further reductions in preventable maternal mortality.
This analysis aimed to assess the service availability and readiness of public health facilities in five provinces of Laos to deliver maternal and newborn healthcare, including basic emergency obstetric and newborn care services (BEmONC).
A cross-sectional survey was conducted In October-November 2023 across 212 health centers and 20 district hospitals under the Laos Maternal Child Health and Nutrition project. Descriptive analysis was used to analyze the data. Service availability was measured based on the number of facilities and beds relative to the population. Service readiness was measured across three domains: guidelines and trained staff, essential equipment and supplies, and essential medicines. A composite readiness score was calculated as the mean across these domains. BEmONC availability was assessed using the presence of seven signal functions.
The overall service availability score was 71.3% across all provinces. The antenatal care readiness score across both facility types was 69.0%, CI95:62.7-75.3%, with district hospitals scoring higher than health centers, at 77.1%, CI95%:75.4-78.8%, compared to 68.2%, CI95%: 62.1-4.3%. The mean readiness score for delivery and newborn care was 68.3%, CI95%: 59.5-77.1%, with district hospitals again performing better at 81.3%, CI95%:79.7-82.9% compared to 67.0%, CI95%:58.2-75.8% for health centers.
Critical gaps in maternal and newborn health services remain, particularly in health centers. Investments in staffing, infrastructure, and availability of equipment and medicines is essential to address current gaps, improve service readiness, and contribute to improved quality of care and health outcomes.
在过去二十年中，全球孕产妇死亡率显著下降，自2000年以来老挝的这一死亡率下降了80%。有效管理产科并发症（孕产妇死亡的主要原因之一）需要人员配备充足、具备基本物资、药品和基础设施的医疗机构。尽管取得了进展，但老挝在服务可及性和准备情况方面仍存在差距，限制了可预防孕产妇死亡率的进一步降低。
本分析旨在评估老挝五个省份的公共卫生设施提供孕产妇和新生儿保健服务的可及性和准备情况，包括基本急诊产科和新生儿护理服务（BEmONC）。
2023年10月至11月，在老挝母婴健康与营养项目下，对212个卫生中心和20家区级医院进行了横断面调查。采用描述性分析对数据进行分析。根据设施数量和床位与人口的比例来衡量服务可及性。从三个方面衡量服务准备情况：指南和经过培训的人员、基本设备和物资、基本药品。计算这三个方面的平均综合准备得分。通过七种信号功能的存在情况评估BEmONC的可及性。
所有省份的总体服务可及性得分为71.3%。两种类型医疗机构的产前护理准备得分均为69.0%，95%置信区间：62.7 - 75.3%，区级医院得分更高，为77.1%，95%置信区间：75.4 - 78.8%，而卫生中心为68.2%，95%置信区间：62.1 - 74.3%。分娩和新生儿护理的平均准备得分为68.3%，95%置信区间：59.5 - 7
