Essential Obstetric Care: A Comprehensive Coverage Evaluation In Adansi-East District, Ghana.

ABSTRACT

A.comprehensive coverage evaluation of essential obstetric care was carried out at the

district referral point and the sub-districts’ first points of contact in the Adansi-East

District, Ashanti Region.

The evaluation tool consisted of measuring the coverage of essential care availability,

access, utilization, adequacy and effectiveness. The essential care variables that were

assessed were labour monitoring by partography, performance of obstetric surgery and the

treatment of non-surgical obstetric complications. Interviews were conducted among

district health managers, service providers, trained traditional birth attendants and women

who delivered 12 months prior to the study, to identify factors causing bottlenecks in the

coverage.

The effectiveness coverage of each essential obstetric care variable was found to be very

low, below 5%. This was mainly due to bottlenecks at resource availability and service

utilization at the district and sub-district levels. There was also a bottleneck at access

coverage at the district level for all the variables. The low availability coverage was due

to lack of ..: . information and training in the use of essential care resources, absence

of resident midwives and lack of rooms to treat cases. The low utilization was as a result

of the inability of the facilities to effectively treat obstetric complications. Most women

with obstetric complications therefore use facilities outside the district.

To improve the effectiveness coverage of essential obstetric care, it is recommended that

the District Health Team reallocates midwives, ensures the provision of a minimal

package of essential resources in each facility, provides life-saving skills training for

essential care providers and strengthens its collaboration with the communities.