TY - JOUR
T1 - Availability and quality of emergency obstetric and neonatal care services in Afghanistan
AU - Kim, Young Mi
AU - Zainullah, Partamin
AU - Mungia, Jaime
AU - Tappis, Hannah
AU - Bartlett, Linda
AU - Zaka, Nabila
N1 - Funding Information:
The authors acknowledge financial support from UNICEF for the study.
PY - 2012/3
Y1 - 2012/3
N2 - Objective: To assess the availability and utilization of emergency obstetric and neonatal care (EmONC) facilities in Afghanistan, as defined by UN indicators. Methods: In a cross-sectional study of 78 first-line referral facilities located in secure areas of Afghanistan, EmONC service delivery was evaluated by using Averting Maternal Deaths and Disabilities (AMDD) Program assessment tools. Results: Forty-two percent of peripheral facilities did not perform all 9 signal functions required of comprehensive EmONC facilities. The study facilities delivered 17% of all neonates expected in their target populations and treated 20% of women expected to experience direct complications. The population-based rate of cesarean delivery was 1%. Most maternal deaths (96%) were due to direct causes. The direct and indirect obstetric case fatality rates were 0.8% and 0.2%, respectively. Conclusion: Notable progress has been made in Afghanistan over the past 8 years in improving the quality, coverage, and utilization of EmONC services, but gaps remain. Re-examination of the criteria for selecting and positioning EmONC facilities is recommended, as is the provision of high-quality, essential maternal and neonatal health services at all levels of the healthcare system, linked by appropriate communication and functional referral systems.
AB - Objective: To assess the availability and utilization of emergency obstetric and neonatal care (EmONC) facilities in Afghanistan, as defined by UN indicators. Methods: In a cross-sectional study of 78 first-line referral facilities located in secure areas of Afghanistan, EmONC service delivery was evaluated by using Averting Maternal Deaths and Disabilities (AMDD) Program assessment tools. Results: Forty-two percent of peripheral facilities did not perform all 9 signal functions required of comprehensive EmONC facilities. The study facilities delivered 17% of all neonates expected in their target populations and treated 20% of women expected to experience direct complications. The population-based rate of cesarean delivery was 1%. Most maternal deaths (96%) were due to direct causes. The direct and indirect obstetric case fatality rates were 0.8% and 0.2%, respectively. Conclusion: Notable progress has been made in Afghanistan over the past 8 years in improving the quality, coverage, and utilization of EmONC services, but gaps remain. Re-examination of the criteria for selecting and positioning EmONC facilities is recommended, as is the provision of high-quality, essential maternal and neonatal health services at all levels of the healthcare system, linked by appropriate communication and functional referral systems.
KW - Afghanistan
KW - Delivery (obstetric/standards)
KW - Emergency obstetric and neonatal care
KW - Health services availability
KW - Maternal health
KW - Neonatal health
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U2 - 10.1016/j.ijgo.2011.10.017
DO - 10.1016/j.ijgo.2011.10.017
M3 - Article
C2 - 22196990
AN - SCOPUS:84856600748
SN - 0020-7292
VL - 116
SP - 192
EP - 196
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
IS - 3
ER -