ArticlePloS one2016
Rural-Urban Inequity in Unmet Obstetric Needs and Functionality of Emergency Obstetric Care Services in a Zambian District.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- WOMEN's Knowledge of Obstetric Danger signs in Ethiopia (WOMEN's KODE):a systematic review and meta-analysis.Systematic reviews · 2019Pooled it
- Barriers to access and utilization of emergency obstetric care at health facilities in sub-Saharan Africa: a systematic review of literature.Systematic reviews · 2018Pooled it
- Urban-rural disparities in receipt of treatment for obstetric complications in Ethiopia: A multivariate decomposition analysis.PloS one · 2026Article
- Give birth in rural hometowns or urban areas? Place of delivery among rural migrant working mothers in the Pearl river delta, China.BMC pregnancy and childbirth · 2025Article
- A systematic review and meta-analysis protocol on knowledge of obstetric danger signs and associated factors among women in Africa.SAGE open medicine · 2023Article
- A Sierra Leone 2021 Midwifery Clinical Training Needs Assessment: A Call to Action to Augment Clinical Precepting.Annals of global health · 2023Article
- Article
- The landscape of disparities in obstetric neurocritical care and a path forward.Frontiers in neurology · 2022Review
- The status of emergency obstetric and newborn care in post-conflict eastern DRC: a facility-level cross-sectional study.Conflict and health · 2021Article
- How maternity waiting home use influences attendance of antenatal and postnatal care.PloS one · 2021Article
- Unmet Healthcare Needs and Associated Factors in Rural and Suburban Vietnam: A Cross-Sectional Study.International journal of environmental research and public health · 2020Article
- Impact of internal female migration on unmet need for modern contraception in Zambia.Reproductive health · 2019Article
- Effect of China's maternal health policy on improving rural hospital delivery: Evidence from two cross-sectional surveys.Scientific reports · 2018Article
- Implementation of a community-based intervention in the most rural and remote districts of Zambia: a process evaluation of safe motherhood action groups.Implementation science : IS · 2018Article
- Barriers to access and utilization of emergency obstetric care at health facilities in sub-Saharan Africa-a systematic review protocol.Systematic reviews · 2018Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundZambia has a high maternal mortality ratio, 398/100,000 live births. Few pregnant women access emergency obstetric care services to handle complications at childbirth. We aimed to assess the deficit in life-saving obstetric services in the rural and urban areas of Kapiri Mposhi district.
methodA cross-sectional survey was conducted in 2011 as part of the 'Response to Accountable priority setting for Trust in health systems' (REACT) project. Data on all childbirths that occurred in emergency obstetric care facilities in 2010 were obtained retrospectively. Sources of information included registers from maternity ward admission, delivery and operation theatre, and case records. Data included age, parity, mode of delivery, obstetric complications, and outcome of mother and the newborn. An approach using estimated major obstetric interventions expected but not done in health facilities was used to assess deficit of life-saving interventions in urban and rural areas.
resultsA total of 2114 urban and 1226 rural childbirths occurring in emergency obstetric care facilities (excluding abortions) were analysed. Facility childbirth constituted 81% of expected births in urban and 16% in rural areas. Based on the reference estimate that 1.4% of childbearing women were expected to need major obstetric intervention, unmet obstetric need was 77 of 106 women, thus 73% (95% CI 71-75%) in rural areas whereas urban areas had no deficit. Major obstetric interventions for absolute maternal indications were higher in urban 2.1% (95% CI 1.60-2.71%) than in rural areas 0.4% (95% CI 0.27-0.55%), with an urban to rural rate ratio of 5.5 (95% CI 3.55-8.76).
conclusionsWomen in rural areas had deficient obstetric care. The likelihood of under-going a life-saving intervention was 5.5 times higher for women in urban than rural areas. Targeting rural women with life-saving services could substantially reduce this inequity and preventable deaths.
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