Status of Emergency Obstetric Care in four districts in Punjab, Pakistan - Results of an EOC Baseline Assessment

Objective

Availability and quality of Skilled Birth Attendance (SBA) and Emergency Obstetric Care (EmONC) are crucial to improve maternal and newborn health. We conducted a survey to assess the availability and quality of EmONC in four districts of Punjab.

Design: Cross sectional descriptive study

Place and Duration: Four districts of Punjab Province, Pakistan were assessed in July 2012.

Patients and Methods: All four District Headquarter Hospitals (DHQs) and 14 Tehsil Headquarter Hospitals (THQs) in four districts and 14 Rural Health Centres (RHCs) in two of the four districts were surveyed using a pre-formatted questionnaire to assess availability of signal functions (SF) of EmONC, including staffing and equipment, number of births and women with complications, maternal case fatality rate (CFR) and still birth rate (SB) at the health facility level.

Results

All required SF were available in 72.2% of health care facilities designated to provide Comprehensive EmONC and 57.1% of facilities designated to provide Basic EmONC. Administration of anticonvulsants and assisted vaginal delivery were the least performed SF. Met need for EmONC was 17.8%, the population-based caesarean section rate was estimated to be 2.7%, the maternal case fatality rate 1.7% and stillbirth rate 3.0%. Eclampsia was the commonest identified cause of maternal death.

Conclusion

Continued efforts are needed to improve the availability and quality of EmONC. The Making it Happen Programme aims to address this through targeted skills-based training and provision of additional equipment for EmONC where needed.