Availability and Quality of Emergency Obstetric and Newborn Care Service in Dire Dawa, Ethiopia

Abstract

Background: Emergency and new born care service (EmONC) is a package of medical interventions that treat the direct obstetric complications. Aim: To assess the availability and quality of emergency obstetric and new born care service in Dire Dawa town health facilities. Methods: Institution based cross sectional study was carried out on emergency obstetric and new born care (EmONC) service in Dire Dawa town of Eastern Ethiopia. All 15 health facilities were assessed. Data was collected using a standard check list that was adopted from WHO, UNICEF AND UNFPA emergency obstetric monitoring handbook and Engenderhealth emergency obstetric quality improvement assessment tool. The data were cleaned, coded and entered into SPSS version 20 for descriptive analysis. Results: Out of 5 hospitals and 1 higher private clinic that were expected to offer comprehensive emergency obstetric and new born care (CEmONC) service, 1 was qualified as CEmONC health facility. Out of 9 health centers that are expected to offer basic emergency obstetrics and new born care (BEmONC) service, 1 was qualified as BEmONC facility. Case fatality rate and population based caesarean section rate were 5.3% and 11.4% respectively. The most frequent direct obstetric complication was severe preeclampsia/eclampsia accounting for 36.6% (117/320). It was also the cause of almost one third of maternal deaths (5/17). Conclusions: BEmONC facility ratio was not adequate while CEmONC facility ratio met the minimum standard. Case fatality rate (CFR) is higher than what is recommended by the UN, which indicates poor quality of EmONC service.