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Coverage of emergency obstetric care and availability of services in public and private health facilities in Bangladesh
Author(s) -
Alam Badrul,
Mridha Malay K.,
Biswas Taposh K.,
Roy Lumbini,
Rahman Maksudur,
Chowdhury Mahbub E.
Publication year - 2015
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2015.04.041
Subject(s) - medicine , private sector , public sector , population , medical emergency , developing country , service provider , public health , environmental health , service (business) , business , nursing , economic growth , marketing , economy , economics
Objective To assess the coverage of emergency obstetric care (EmOC) and the availability of obstetric services in Bangladesh. Methods In a national health facility assessment performed between November 2007 and July 2008, all public EmOC facilities and private facilities providing obstetric services in the 64 districts of Bangladesh were mapped. The performance of EmOC services in these facilities during the preceding month was investigated using a semi‐structured questionnaire completed through interviews of managers and service providers, and record review. Results In total, 8.6 (2.1 public and 6.5 private) facilities per 500 000 population offered obstetric care services. Population coverage by obstetric care facilities varied by region. Among 281 public facilities designated for comprehensive EmOC, cesarean delivery was available in only 215 (76.5%) and blood transfusion services in 198 (70.5%). In the private sector (for profit and not for profit), these services were available in more than 80% of facilities. In all facility types, performance of assisted vaginal delivery (range 12.2%–48.4%) and use of parenteral anticonvulsants to treat pre‐eclampsia/eclampsia (range 48.6%–80.8%) were low. The main reason for non‐availability of EmOC services was a lack of specialist/trained providers. Conclusion Bangladesh needs to increase the availability of EmOC services through innovative public–private partnerships. In the public sector, additional trained manpower supported by an incentivized package should be deployed.