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Improving obstetric care at the district hospital, Ekpoma, Nigeria
Author(s) -
Ande B,
Chiwuzie J,
Akpala W,
Oronsaye A,
Okojie O,
Okolocha C,
Omorogbe S,
Onoguwe B,
Oikeh E
Publication year - 1997
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/s0020-7292(97)00147-1
Subject(s) - medicine , psychological intervention , government (linguistics) , obstetrics and gynaecology , community hospital , family medicine , emergency medicine , nursing , pregnancy , linguistics , philosophy , biology , genetics
Preliminary studies: Facility reviews and focus group discussions revealed several factors at the district hospital contributing to maternal deaths in Ekpoma District, Nigeria. Interventions: In response, the necessary equipment for the operating theater, labor suite and laboratory were repaired or purchased. A blood bank and standby generator were repaired. Drugs and consumable material were purchased and a revolving fund established. Refresher courses were held for medical officers, nursing staff and laboratory technicians. At a later stage, community interventions focused on improving access and reducing delay in seeking care. Results: The number of cesarean sections performed increased from zero in 1990–1991 to between seven and 13/year in the period 1992–1995. The number of women with major obstetric complications seen at the hospital increased from seven in 1990 (5% of obstetric admissions) to a high of 29 (20% of obstetric admissions) in 1993. These gains were not sustained, however. In 1995, only 12 women with complications (9% of obstetric admissions) were seen. Costs: The cost of improvements was approximately US $12 800, of which 41% was paid by the government and the rest by the project. Conclusions: Improving obstetric care at the district hospital can increase use by women with complications. However, sociopolitical and economic problems can hamper success. © 1997 International Federation of Gynecology and Obstetrics