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Int J Gynaecol Obstet. 2007 Mar;96(3):220-5. Epub 2007 Feb 8.

Emergency obstetric care as the priority intervention to reduce maternal mortality in Uganda.

Author information

1
Ministry of Health, Kampala, Uganda. vpadmn@infocom.co.ug

Abstract

PURPOSE:

We conducted a survey to determine availability of emergency obstetric care (EmOC) to provide baseline data for monitoring provision of obstetric care services in Uganda.

METHODS:

The survey, covering 54 districts and 553 health facilities, assessed availability of EmOC signal functions. Following this, performance improvement process was implemented in 20 district hospitals to scale-up EmOC services.

FINDINGS:

A maternal mortality ratio (MMR) of 671/100,000 live births was recorded. Hemorrhage, 42.2%, was the leading direct cause of maternal deaths, and malaria accounted for 65.5% of the indirect causes. Among the obstetric complications, abortion accounted for 38.9% of direct and malaria 87.4% of indirect causes. Removal of retained products (OR 3.3, P<0.002), assisted vaginal delivery (OR 3.3, P<0.001) and blood transfusion (OR 13.7, P<0.001) were the missing signal functions contributing to maternal deaths. Most health facilities expected to offer basic EmOC, 349 (97.2%) were not offering them. Using the performance improvement process, availability of EmOC in the 20 hospitals improved significantly.

CONCLUSION:

An integrated programming approach aiming at increasing access to EmOC, malaria treatment and prevention services could reduce maternal mortality in Uganda.

PMID:
17292370
DOI:
10.1016/j.ijgo.2006.12.017
[Indexed for MEDLINE]

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