RMM Programme: Some remaining challenges
02/10/11
There has been a substantially improvement in the number of institutions providing comprehensive emergency obstetric care (from about 1 per 1.200.000 population in 2008 to 1 per 250.000 population at the end of 2010; see following table). Although this is an essential requirement to cut maternal and neonatal deaths, the use of such services remains below what is needed to reduce maternal and neonatal deaths. However, lack of ambulance services remains a great challenge.
It is also important, as asked by the zonal health authorities, to increase the number of institutions carrying our CEOC with 6. At the end of 2015, the area will then have one institution per 160.000 people. This is about the target the Ethiopian Government has set during the next five years.
Our study shows that of the 64 major health institutions in Gamu Gofa Zone, only a few were carrying out Basic Emergency Obstetric care. We therefore think it is essential to include these institutions in our future programme, and thereby improving the access of the population to such services, and to improve referrals to institutions with CEOC.
Although staff retention has been good, it is important to sustain staffing the institutions. Of particular importance is to improve the skills so more operations can be done at these remote institutions. We therefore aim to support a masters programme for health officers at Arba Minch University.
The main causes of maternal deaths, as documented by our review of health institutions and by our population-based registries, show that bleedings, infections and pre-eclampsia represent the main cases of death. As most of the births still occur at home and attended by traditional birth attendants or family members, we need to find ways to reduce bleedings and infections during home deliveries.
Several of the institutions carrying out CEOC do not functioning optimally because they lack adequate blood transfusion services. To reduce maternal deaths from bleeding and from uterine ruptures we need to improve the blood transfusion services at these institutions.
It is also important, as asked by the zonal health authorities, to increase the number of institutions carrying our CEOC with 6. At the end of 2015, the area will then have one institution per 160.000 people. This is about the target the Ethiopian Government has set during the next five years.
Our study shows that of the 64 major health institutions in Gamu Gofa Zone, only a few were carrying out Basic Emergency Obstetric care. We therefore think it is essential to include these institutions in our future programme, and thereby improving the access of the population to such services, and to improve referrals to institutions with CEOC.
Although staff retention has been good, it is important to sustain staffing the institutions. Of particular importance is to improve the skills so more operations can be done at these remote institutions. We therefore aim to support a masters programme for health officers at Arba Minch University.
The main causes of maternal deaths, as documented by our review of health institutions and by our population-based registries, show that bleedings, infections and pre-eclampsia represent the main cases of death. As most of the births still occur at home and attended by traditional birth attendants or family members, we need to find ways to reduce bleedings and infections during home deliveries.
Several of the institutions carrying out CEOC do not functioning optimally because they lack adequate blood transfusion services. To reduce maternal deaths from bleeding and from uterine ruptures we need to improve the blood transfusion services at these institutions.
