BMC Pregnancy and Childbirth | |
Readiness of district and regional hospitals in Burkina Faso to provide caesarean section and blood transfusion services: a cross-sectional study | |
Matthias Borchert2  Vincent De Brouwere4  Nicolas Meda5  Sennen Hounton1  Rasmané Ganaba3  Issiaka Sombié5  Georges Dayitaba Compaoré5  | |
[1] Technical Division, United Nations Population Fund, New-York, NY, USA;Institute of Tropical Medicine and International Health, Charité – Universitätsmedizin Berlin, Berlin, Germany;AFRICSanté, Bobo-Dioulasso, Burkina Faso;Institute of Tropical Medicine, Antwerp, Belgium;Centre Muraz, Bobo-Dioulasso, Burkina Faso, PO Box 390, Bobo-Dioulasso, Burkina Faso | |
关键词: Burkina Faso; Blood transfusion; Caesarean section; Hospitals; Readiness; | |
Others : 1127349 DOI : 10.1186/1471-2393-14-158 |
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received in 2013-12-26, accepted in 2014-04-24, 发布年份 2014 | |
【 摘 要 】
Background
Health centres and hospitals play a crucial role in reducing maternal mortality and morbidity by offering respectively Basic Emergency Obstetric and Newborn Care (BEmONC) and Comprehensive Emergency Obstetric and Newborn Care (CEmONC). The readiness of hospitals to provide CEmONC depends on the availability of qualified human resources, infrastructure like surgical theatres, and supplies like drugs and blood for transfusion. We assessed the readiness of district and regional hospitals in Burkina Faso to provide two key CEmONC functions, namely caesarean section and blood transfusion. As countries conduct EmONC needs assessments it is critical to provide national and subnational data, e.g. on the distribution of EmONC facilities as well as on facilities lacking the selected signal functions, to support the planning process for upgrading facilities so that they are ready to provide CEmONC.
Methods
In a cross-sectional study we assessed the availability of relevant health workers, obstetric guidelines, caesarean section and blood transfusion services and experience with quality assurance approaches across all forty-three (43) district and nine (9) regional hospitals.
Results
The indicator corresponding to one comprehensive emergency care unit for 500,000 inhabitants was not achieved in Burkina Faso. Physicians with surgical skills, surgical assistants and anaesthesiologist assistants are sufficiently available in only 51.2%, 88.3% and 72.0% of district hospitals, respectively. Two thirds of regional and 20.9% of district hospitals had blood banks. Most district hospitals as opposed to only one third of regional hospitals had experience in maternal death reviews.
Conclusions
Our findings suggest that only 27.8% of hospitals in Burkina Faso at the time of the study could continuously offer caesarean sections and blood transfusion services. Four years later, progress has likely been made but many challenges remain to be overcome. Information provided in this study can serve as a baseline for monitoring progress in district and regional hospitals.
【 授权许可】
2014 Compaoré et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
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20150220112846753.pdf | 562KB | download | |
Figure 2. | 31KB | Image | download |
Figure 1. | 87KB | Image | download |
【 图 表 】
Figure 1.
Figure 2.
【 参考文献 】
- [1]WHO, UNICEF, UNFPA, The World Bank: Trends in Maternal Mortality: 1990 to 2010. Geneva, Switzerland: World Health Organization; 2012.
- [2]Mpemba F, Kampo S, Zhang X: Towards 2015: post-partum haemorrhage in sub-Saharan Africa still on the rise. J Clin Nurs 2014, 23(5–6):774-783.
- [3]Paxton A, Maine D, Freedman L, Fry D, Lobis S: The evidence for emergency obstetric care. Int J Gynaecol Obstet 2005, 88(2):181-193.
- [4]Graham W, Bell J, Bullough C: Can Skilled Attendance at Delivery Reduce Maternal Mortality in Developping Countries? In Safe Motherhood Strategies: A review of the Evidence. Edited by De Brouwere V, Van Lerberghe W. Antwerp: Stud Health Serv Organ Policy ITG Press; 2001.
- [5]Van Lerberghe W, Van Balen H, Kegels G: Typology and performance of first-referral hospitals in sub-saharan Africa. Ann Soc Belg Med Trop 1992, 72(Suppl 2):1-51.
- [6]Skupski DW, Lowenwirt IP, Weinbaum FI, Brodsky D, Danek M, Eglinton GS: Improving hospital systems for the care of women with major obstetric hemorrhage. Obstet Gynecol 2006, 107(5):977-983.
- [7]Blas E, Limbambala M: The challenge of hospitals in health sector reform: the case of Zambia. Health Policy Plan 2001, 16(Suppl 2):29-43.
- [8]Gill Z, Bailey P, Waxman R, Smith JB: A tool for assessing ‘readiness’ in emergency obstetric care: the room-by-room ‘walk-through’. Int J Gynaecol Obstet 2005, 89(2):191-199.
- [9]Paxton A, Bailey P, Lobis S, Fry D: Global patterns in availability of emergency obstetric care. Int J Gynaecol Obstet 2006, 93(3):300-307.
- [10]Mbonye AK, Asimwe JB, Kabarangira J, Nanda G, Orinda V: Emergency obstetric care as the priority intervention to reduce maternal mortality in Uganda. Int J Gynaecol Obstet 2007, 96(3):220-225.
- [11]Islam MT, Haque YA, Waxman R, Bhuiyan AB: Implementation of emergency obstetric care training in Bangladesh: lessons learned. Reprod Health Matters 2006, 14(27):61-72.
- [12]Hounton SH, Newlands D, Meda N, De Brouwere V: A cost-effectiveness study of caesarean-section deliveries by clinical officers, general practitioners and obstetricians in Burkina Faso. Hum Resour Health 2009, 7:34. BioMed Central Full Text
- [13]Bodart C, Servais G, Mohamed YL, Schmidt-Ehry B: The influence of health sector reform and external assistance in Burkina Faso. Health Policy Plan 2001, 16(1):74-86.
- [14]Haddad S, Nougtara A, Fournier P: Learning from health system reforms: lessons from Burkina Faso. Tropical Med Int Health: TM & IH 2006, 11(12):1889-1897.
- [15]EngenderHealth, AMDD-Mailman School of Public Health-Columbia University: Quality improvement for emergency obstetric care. In Leadership manual. New York: EngenderHealth; 2003.
- [16]Ministère de la Santé: Evaluation des besoins en Soins Obstétricaux et Néonataux d'Urgence, couplée à la cartographie de l'offre de soins en Santé de la Reproduction au Burkina Faso. Ouagadougou: Ministère de la Santé; 2012.
- [17]WHO, UNFPA, UNICEF & AMDD: Monitoring Emergency Obstetric Care a Handbook: WHO, UNFPA, UNICEF & AMDD, World Health Organization. 2009. http://whqlibdoc.who.int/publications/2009/9789241547734_eng.pdf webcite
- [18]Mullan F, Frehywot S: Non-physician clinicians in 47 sub-Saharan African countries. Lancet 2007, 370(9605):2158-2163.
- [19]Gessessew A, Barnabas GA, Prata N, Weidert K: Task shifting and sharing in Tigray, Ethiopia, to achieve comprehensive emergency obstetric care. Int J Gynecol Obstet 2011, 113(1):28-31.
- [20]Pereira C, Cumbi A, Malalane R, Vaz F, McCord C, Bacci A, Bergström S: Meeting the need for emergency obstetric care in Mozambique: work performance and histories of medical doctors and assistant medical officers trained for surgery. BJOG: Int J Obstetr Gynaecol 2007, 114(12):1530-1533.
- [21]Chilopora G, Pereira C, Kamwendo F, Chimbiri A, Malunga E, Bergstrom S: Postoperative outcome of caesarean sections and other major emergency obstetric surgery by clinical officers and medical officers in Malawi. Hum Resour Health 2007, 5(1):17. BioMed Central Full Text
- [22]Hounton S, Chapman G, Menten J, De Brouwere V, Ensor T, Sombie I, Meda N, Ronsmans C: Accessibility and utilisation of delivery care within a skilled care initiative in rural Burkina Faso. Tropical Med Int Health: TM & IH 2008, 13(Suppl 1):44-52.
- [23]Countdown to 2015, Maternal, Newborn & Child Survival http://www.countdown2015mnch.org/country-profiles/burkina-faso webcite, accessed the 13 November 2013