The University of Southampton
University of Southampton Institutional Repository

The state of emergency obstetric care services in Nairobi informal settlements and environs: results from a maternity health facility survey.

Ziraba, Abdhalah K., Mills, Samuel, Madise, Nyovani, Saliku, Teresa and Fotso, Jean-Christophe (2009) The state of emergency obstetric care services in Nairobi informal settlements and environs: results from a maternity health facility survey. BMC Health Services Research, 9, (46), pp. 1-8. (doi:10.1186/1472-6963-9-46).

Record type: Article

Abstract

Background: maternal mortality in Sub-Saharan Africa remains a challenge with estimates exceeding 1,000 maternal deaths per 100,000 live births in some countries. Successful prevention of maternal deaths hinges on adequate and quality emergency obstetric care. In addition to skilled personnel, there is need for a supportive environment in terms of essential drugs and supplies, equipment, and a referral system. Many household surveys report a reasonably high proportion of women delivering in health facilities. However, the quality and adequacy of facilities and personnel are often not assessed. The three delay model; 1) delay in making the decision to seek care; 2) delay in reaching an appropriate obstetric facility; and 3) delay in receiving appropriate care once at the facility guided this project. This paper examines aspects of the third delay by assessing quality of emergency obstetric care in terms of staffing, skills equipment and supplies.
Methods: we used data from a survey of 25 maternity health facilities within or near two slums in Nairobi that were mentioned by women in a household survey as places that they delivered. Ethical clearance was obtained from the Kenya Medical Research Institute. Permission was also sought from the Ministry of Health and the Medical Officer of Health. Data collection included interviews with the staff in-charge of maternity wards using structured questionnaires. We collected information on staffing levels, obstetric procedures performed, availability of equipment and supplies, referral system and health management information system.
Results: out of the 25 health facilities, only two met the criteria for comprehensive emergency obstetric care (both located outside the two slums) while the others provided less than basic emergency obstetric care. Lack of obstetric skills, equipment, and supplies hamper many facilities from providing lifesaving emergency obstetric procedures. Accurate estimation of burden of morbidity and mortality was a challenge due to poor and incomplete medical records.
Conclusion: the quality of emergency obstetric care services in Nairobi slums is poor and needs improvement. Specific areas that require attention include supervision, regulation of maternity facilities; and ensuring that basic equipment, supplies, and trained personnel are available in order to handle obstetric complications in both public and private facilities

PDF 1472-6963-9-46.pdf - Version of Record
Download (447kB)

More information

Published date: 2009

Identifiers

Local EPrints ID: 71064
URI: http://eprints.soton.ac.uk/id/eprint/71064
ISSN: 1472-6963
PURE UUID: 3216e927-680e-4f6e-b3c9-d076b0325c51
ORCID for Nyovani Madise: ORCID iD orcid.org/0000-0002-2813-5295

Catalogue record

Date deposited: 13 Jan 2010
Last modified: 19 Jul 2017 00:02

Export record

Altmetrics

Contributors

Author: Abdhalah K. Ziraba
Author: Samuel Mills
Author: Nyovani Madise ORCID iD
Author: Teresa Saliku
Author: Jean-Christophe Fotso

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×