Reducing Maternal Mortality: an Assessment of the Availability and Quality of Emergency Obstetric and Newborn Care in Esan Central Local Government Area of Edo State
Abstract BackgroundThere is global public health burden of maternal mortality and is worse in Sub-Saharan Africa. Esan Central LGA in Nigeria has an estimated maternal mortality of 1747 per 100,000 live births which is unacceptably high. Emergency obstetric care has been advocated as a measure to avert maternal mortality as about 15% of pregnancies developed complications which may be unpredictable. There is therefore need to access the availability and quality of EmOC in the area. This study aimed to assess the availability and quality of emergency obstetric and newborn care (EmONC) services in the areaMethodsWe conducted a descriptive cross-sectional study and an in-depth interview. Data was collected using UN/AMDD assessment tools (Handbook). Forty key informants’ interviews with major facility managers, pregnant women and health care providers were also done and triangulated. Analysis was done using IBM SPSS statistics- 20, while the in-depth interviews were audio taped, transcribed and analyzed by thematic coding. In addition EmONC services indicators were calculated.ResultThe availability of EmONC services in Esan central LGA was 3.7/500,000 population. The availability of EmONC services was limited at the primary and secondary level of health care. The comprehensive EmOC was adequate (3.7/500000 population) and it is available at the tertiary health facility. The met need for EmONC was 62.6%, obstetric case fatality was 1.2%, and caesarean section rate was 24 %, while the still birth rate was 2.6%. The respondents had adequate knowledge and concern about the burden of maternal death. Major causes of maternal death reported were haemorrhage, hypertension / convulsion in pregnancy and prolong labour. Major contributing factors to maternal death are lack of money, poor antenatal care, and poor attitudes of health care providers, inappropriate referral network, lack of equipment and EmONC drugs, inadequate skill birth attendants and delay in getting treatment. Overall remark on the quality of EmONC services was poor.Conclusion There are limited EmONC services at the primary and secondary health centers that require urgent attention in effort to reducing maternal mortality. There is need for supply of equipment, emergency obstetric care drugs, training and re-training of staff. The community and the health care providers need re-orientation as to the reproductive health care requirements of the people in such a manner that is client centered and with appropriate referral network.