Estimating the met need for emergency obstetric care (EmOC) services in three payams of Torit County, South Sudan: a facility-based, retrospective cross-sectional study
Objective To determine the met need for emergency obstetric care (EmOC) services in three Payams of Torit County, South Sudan in 2015 and to determine the frequency of each major obstetric complication.Design This was a retrospective cross-sectional study.Setting Four primary healthcare centres (PHC...
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BMJ Publishing Group
2018-02-01
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| Series: | BMJ Open |
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| author | Pontius Bayo Imose Itua Suzie Paul Francis Kofi Boateng Elijo Omoro Tahir Abdulmumini Usman |
| author_facet | Pontius Bayo Imose Itua Suzie Paul Francis Kofi Boateng Elijo Omoro Tahir Abdulmumini Usman |
| author_sort | Pontius Bayo |
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| description | Objective To determine the met need for emergency obstetric care (EmOC) services in three Payams of Torit County, South Sudan in 2015 and to determine the frequency of each major obstetric complication.Design This was a retrospective cross-sectional study.Setting Four primary healthcare centres (PHCCs) and one state hospital in three payams (administrative areas that form a county) in Torit County, South Sudan.Participants All admissions in the obstetrics and gynaecology wards (a total of 2466 patient admission files) in 2015 in all the facilities designated to conduct deliveries in the study area were reviewed to identify obstetric complications.Primary and secondary outcome measures The primary outcome was met need for EmOC, which was defined as the proportion of all women with direct major obstetric complications in 2015 treated in health facilities providing EmOC services. The frequency of each complication and the interventions for treatment were the secondary outcomes.Results Two hundred and fifty four major obstetric complications were admitted in 2015 out of 390 expected from 2602 pregnancies, representing 65.13% met need. The met need was highest (88%) for Nyong Payam, an urban area, compared with the other two rural payams, and 98.8% of the complications were treated from the hospital, while no complications were treated from three PHCCs. The most common obstetric complications were abortions (45.7%), prolonged obstructed labour (23.2%) and haemorrhage (16.5%). Evacuation of the uterus for retained products (42.5%), caesarean sections (32.7%) and administration of oxytocin for treatment of postpartum haemorrhage (13.3%) were the most common interventions.Conclusion The met need for EmOC in Torit County is low, with 35% of women with major obstetric complications not accessing care, and there is disparity with Nyong Payam having a higher met need. We suggest more support supervision to the PHCCs to increase access for the rural population. |
| format | Article |
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| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2018-02-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-eb9d8471120c4a7fb33e71df2fa8ef232025-02-08T22:30:09ZengBMJ Publishing GroupBMJ Open2044-60552018-02-018210.1136/bmjopen-2017-018739Estimating the met need for emergency obstetric care (EmOC) services in three payams of Torit County, South Sudan: a facility-based, retrospective cross-sectional studyPontius Bayo0Imose Itua1Suzie Paul Francis2Kofi Boateng3Elijo Omoro Tahir4Abdulmumini Usman54 St Mary`s Lacor Hospital, Gulu, Uganda3 School of Public Health, University of Liverpool, Liverpool, UK2 Department of Maternal and Child Health, WHO, Juba, South Sudan4 EPI Department, WHO, Juba, South Sudan5 Department of Pharmaceuticals, Torit State Hospital, Torit, South SudanWorld Health Organization Regional Office for Africa, Brazzaville, Republic of CongoObjective To determine the met need for emergency obstetric care (EmOC) services in three Payams of Torit County, South Sudan in 2015 and to determine the frequency of each major obstetric complication.Design This was a retrospective cross-sectional study.Setting Four primary healthcare centres (PHCCs) and one state hospital in three payams (administrative areas that form a county) in Torit County, South Sudan.Participants All admissions in the obstetrics and gynaecology wards (a total of 2466 patient admission files) in 2015 in all the facilities designated to conduct deliveries in the study area were reviewed to identify obstetric complications.Primary and secondary outcome measures The primary outcome was met need for EmOC, which was defined as the proportion of all women with direct major obstetric complications in 2015 treated in health facilities providing EmOC services. The frequency of each complication and the interventions for treatment were the secondary outcomes.Results Two hundred and fifty four major obstetric complications were admitted in 2015 out of 390 expected from 2602 pregnancies, representing 65.13% met need. The met need was highest (88%) for Nyong Payam, an urban area, compared with the other two rural payams, and 98.8% of the complications were treated from the hospital, while no complications were treated from three PHCCs. The most common obstetric complications were abortions (45.7%), prolonged obstructed labour (23.2%) and haemorrhage (16.5%). Evacuation of the uterus for retained products (42.5%), caesarean sections (32.7%) and administration of oxytocin for treatment of postpartum haemorrhage (13.3%) were the most common interventions.Conclusion The met need for EmOC in Torit County is low, with 35% of women with major obstetric complications not accessing care, and there is disparity with Nyong Payam having a higher met need. We suggest more support supervision to the PHCCs to increase access for the rural population.https://bmjopen.bmj.com/content/8/2/e018739.full |
| spellingShingle | Pontius Bayo Imose Itua Suzie Paul Francis Kofi Boateng Elijo Omoro Tahir Abdulmumini Usman Estimating the met need for emergency obstetric care (EmOC) services in three payams of Torit County, South Sudan: a facility-based, retrospective cross-sectional study BMJ Open |
| title | Estimating the met need for emergency obstetric care (EmOC) services in three payams of Torit County, South Sudan: a facility-based, retrospective cross-sectional study |
| title_full | Estimating the met need for emergency obstetric care (EmOC) services in three payams of Torit County, South Sudan: a facility-based, retrospective cross-sectional study |
| title_fullStr | Estimating the met need for emergency obstetric care (EmOC) services in three payams of Torit County, South Sudan: a facility-based, retrospective cross-sectional study |
| title_full_unstemmed | Estimating the met need for emergency obstetric care (EmOC) services in three payams of Torit County, South Sudan: a facility-based, retrospective cross-sectional study |
| title_short | Estimating the met need for emergency obstetric care (EmOC) services in three payams of Torit County, South Sudan: a facility-based, retrospective cross-sectional study |
| title_sort | estimating the met need for emergency obstetric care emoc services in three payams of torit county south sudan a facility based retrospective cross sectional study |
| url | https://bmjopen.bmj.com/content/8/2/e018739.full |
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