Assessment Of Readiness And Extent Of Utilization Of Emergency Obstetric Care Facilities In Arua District

ABSTRACT.

Maternal mortality ratio in Uganda has been declining over the past years but has remained unacceptably high at 438 maternal deaths per 100,000 live births. This is majorly accounted for by the 5 direct obstetric complications; haemorrhage, sepsis, obstructed labour, complications of abortion and hypertensive disorders in pregnancy contributing over 85% of the deaths. In light of this fact, the researcher therefore assessed health facility readiness in Arua district to deal with these complications in the public health facilities.

A descriptive cross sectional study carried out in Arua district employed both qualitative and quantitative study approaches for data collection. Thirty percent (7) of the health facilities were selected for this study from 2 health sub-districts. These were selected by means of simple random selection. Data was collected by face to face interviews, questionnaires and observation checklist.

There was at least one staff in all selected health facilities, able to carry out most of the signal functions. The only health center IV had a none functional theater and lacked blood although there was a doctor available. All (100%) of the facilities had Oxytocin, vaginal speculum and some antibiotics while a good fraction (71%) had Magnessium sulphate. None of the facilities had a manual vacuum extractor although only 14% of the facilities had D&C set however; all facilities provided at most 10% to 30% of the signal functions. Health facility deliveries averaged to 45% and met need for EmOC at 34%.

Therefore, health facility readiness to handle direct obstetric complications is still not enough due to lack of some of the necessary resources and staff inability to carry out a number of the signal functions. Low utilization of EmOC services attributed to low capacity to provide a full range of EmOC services. Addressing gaps in facilities readiness for EmOC requires strengthening service provider’s clinical and problem solving skills through in-service trainings like onsite mentoring and support supervision programs. This should be accompanied by health systems response to procure all the missing medicines and supplies/equipment for the provision of EmOC services.