Availability, Utilisation and Quality of Basic and Comprehensive Emergency Obstetric Care Services in Malawi
- 26 June 2008
- journal article
- Published by Springer Science and Business Media LLC in Maternal and Child Health Journal
- Vol. 13 (5), 687-694
- https://doi.org/10.1007/s10995-008-0380-y
Abstract
Objective To establish a baseline for the availability, utilisation and quality of maternal and neonatal health care services for monitoring and evaluation of a maternal and neonatal morbidity/mortality reduction programme in three districts in the Central Region of Malawi. Methods Survey of all the 73 health facilities (13 hospitals and 60 health centres) that provide maternity services in the three districts (population, 2,812,183). Results There were 1.6 comprehensive emergency obstetric care (CEmOC) facilities per 500,000 population and 0.8 basic emergency obstetric care (BEmOC) facilities per 125,000 population. About 23% of deliveries were conducted in emergency obstetric care (EmOC) facilities and the met need for emergency obstetric complications was 20.7%. The case fatality rate for emergency obstetric complications treated in health facilities was 2.0%. Up to 86.7% of pregnant women attended antenatal clinic at least once and only 12.0% of them attend postnatal clinic at least once. There is a shortage of qualified staff and unequal distribution with more staff in hospitals leaving health centres severely understaffed. Conclusions The total number of CEmOC facilities is adequate but the distribution is unequal, leaving some rural areas with poor access to CEmOC services. There are no functional BEmOC facilities in the three districts. In order to reduce maternal mortality in Malawi and countries with similar socio-economic profile, there is a need to upgrade some health facilities to at least BEmOC level by training staff and providing equipment and supplies.Keywords
This publication has 16 references indexed in Scilit:
- Evidence‐Based Strategies for Reducing Cesarean Section Rates: A Meta‐AnalysisBirth, 2007
- Costs and coverage of reproductive health interventions in three rural refugee‐affected districts, UgandaTropical Medicine & International Health, 2007
- Perceptions and attitudes of pregnant women towards caesarean section in urban NigeriaActa Obstetricia et Gynecologica Scandinavica, 2007
- Factors Influencing Women's Choice of Place of Delivery in Rural Malawi-An Explorative Study / Facteurs qui influent sur le choix fait par la femme de lieu d'accouchement au Malawi rural: Une étude explorativeAfrican Journal of Reproductive Health, 2006
- Maternal mortality: who, when, where, and whyThe Lancet, 2006
- Global patterns in availability of emergency obstetric careInternational Journal of Gynecology & Obstetrics, 2006
- Program note: using UN process indicators to assess needs in emergency obstetric services: Morocco, Nicaragua and Sri LankaInternational Journal of Gynecology & Obstetrics, 2003
- Monitoring obstetric services: putting the ‘UN Guidelines’ into practice in Malawi: 3 years onInternational Journal of Gynecology & Obstetrics, 2001
- WHO systematic review of randomised controlled trials of routine antenatal careThe Lancet, 2001
- Are Brazilian women really choosing to deliver by cesarean?Social Science & Medicine (1982), 2000