Basic and comprehensive emergency obstetric and\ud neonatal care in 12 South African health districts

Article English OPEN
Pattinson, RC ; Makin, JD ; Pillay, Y ; van den Broek, Nynke ; Moodley, J (2015)
  • Publisher: Health and Medical Publications Group
  • Related identifiers: doi: 10.7196/samj.9181
  • Subject: wq_200 | wq_240 | wp_100

Aim. To assess the functionality of healthcare facilities with respect to providing the signal functions of basic and comprehensive emergency obstetric care in 12 districts.\ud Setting. Twelve districts were selected from the 52 districts in South Africa, based on the number of maternal deaths, the institutional maternal mortality ratio and the stillbirth rate for the district.\ud Methods. All community health centres (CHCs) and district, regional and tertiary hospitals were visited and detailed information was obtained on the ability of the facility to perform the basic (BEmONC) and comprehensive (CEmONC) emergency obstetric and neonatal\ud care signal functions.\ud Results. Fifty-three CHCs, 63 district hospitals (DHs), 13 regional hospitals and 4 tertiary hospitals were assessed. None of the CHCs\ud could perform all seven BEmONC signal functions; the majority could not give parenteral antibiotics (68%), perform manual removal of the placenta (58%), do an assisted delivery (98%) or perform manual vacuum aspiration of the uterus in a woman with an uncomplicated\ud incomplete miscarriage (96%). Seventeen per cent of CHCs could not bag-and-mask ventilate a neonate. Less than half (48%) of the DHs could perform all nine CEmONC signal functions (81% could perform eight of the nine functions), 24% could not perform caesarean\ud sections, and 30% could not perform assisted deliveries.\ud Conclusions. The ability of the CHCs and district hospitals to perform the signal functions (lifesaving services) of basic and comprehensive emergency obstetric care was poor in many of the districts studied. This implies that safe maternity care was not consistently available at many facilities conducting births.
  • References (16)
    16 references, page 1 of 2

    1. Dorrington RE, Bradshaw D, Laubscher R. Rapid Mortality Surveillance Report 2012. Cape Town: South African Medical Research Council, 2014.

    2. Pattinson RC, ed. Saving Mothers 2011-2013: eTh Sixth Report of the National Committee for Confidential Enquiries into Maternal Deaths in South Africa. Pretoria: Government Printer, 2014.

    3. Rooks JP, Weatherby NL, Ernst EK, Stapleton S, Rosen D, Rosenfield A. Outcomes of care in birth centers: eTh National Birth Center Study. N Engl J Med 1989;321(26):1804-1811. [http://dx.doi. org/10.1056/NEJM198912283212606]

    4. Birthplace in England Collaborative Group. Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: eTh Birthplace in England national prospective cohort study. BMJ 2011;343:d7400. [http://dx.doi.org/10.1136/bmj.d7400]

    5. Kerber K. Triple return for our rand: How many South African mothers and babies can be saved and what is the cost? Presented at the 30th Annual Priorities in Perinatal Care Conference, Safari Lodge, Polokwane, 8-10 March 2011.

    6. Pattinson R, Kerber K, Buchmann E, et al., for eTh Lancet's Stillbirths Series steering team. Stillbirths: How can health systems deliver for mothers and babies? Lancet 2011;377(9777):1610-1623. [http:// dx.doi.org/10.1016/S0140-6736(10)62306-9]

    7. World Health Organization. Monitoring Emergency Obstetric Care: A Handbook. Geneva: WHO, 2009.

    8. Frank K, Lombaard H, Pattinson RC. Does completion of the Essential Steps in Managing Obstetric Emergencies (ESMOE) training package result in improved knowledge and skills in managing obstetric emergencies? S Afr J Obstet Gynaecol 2009;15(3):94-99.

    9. De Jonge ETM, Venter CP, de Wet GH, Pattinson RC. Improving care for patients undergoing curettage for incomplete abortion. S Afr Med J 1996;86(9):1172-1174.

    10. Pattinson RC. Saving Babies 2010-2011: eTh Eighth Report on Perinatal Care in South Africa. Pretoria: Tshepesa Press, 2012.

  • Metrics
    No metrics available
Share - Bookmark