ArticlePloS one2018
Measuring the preparedness of health facilities to deliver emergency obstetric care in a South African district.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Criteria based clinical audit of selected obstetric emergencies standard of care and feto-maternal outcomes in public hospitals of West Shoa Zone, Central Ethiopia.BMC pregnancy and childbirth · 2026Article
- Clinical factors associated with severe maternal outcomes in two South African hospitals: A case-control study.PloS one · 2026Article
- Strengthening teamwork and respect (STAR) in maternity units: developing a health system intervention in South Africa.Global health action · 2025Article
- Hospital readiness for the provision of care to critically ill patients in Tanzania- an in-depth cross-sectional study.BMC health services research · 2024Article
- Trends, Projections, and Regional Disparities of Maternal Mortality in Africa (1990-2030): An ARIMA Forecasting Approach.Epidemiologia (Basel, Switzerland) · 2023Article
- Health managers and community representatives' views of a system-wide intervention to strengthen public healthcare in the Free State, South Africa.African health sciences · 2023Article
- Effective Coverage of Emergency Obstetric and Newborn Care Services in Africa: A Scoping Review.Open access emergency medicine : OAEM · 2023Article
- Assessment of service readiness for maternity care in primary health centres in rural Nigeria: implications for service improvement.The Pan African medical journal · 2021Article
- 'It needs a complete overhaul…' district manager perspectives on the capacity of the health system to support the delivery of emergency obstetric care in an urban South African district.Global health action · 2019Article
- Birth preparedness among women in early labor: A qualitative study in Durban, South Africa.Women's health (London, England)Article
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3 authors.
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Abstract
backgroundImproving the delivery of emergency obstetric care (EmNOC) remains critical in addressing direct causes of maternal mortality. United Nations (UN) agencies have promoted standard methods for evaluating the availability of EmNOC facilities although modifications have been proposed by others. This study presents an assessment of the preparedness of public health facilities to provide EmNOC using these methods in one South African district with a persistently high maternal mortality ratio.
methodsData collection took place in the final quarter of 2014. Cross-sectional surveys were conducted to classify the 7 hospitals and 8 community health centres (CHCs) in the district as either basic EmNOC (BEmNOC) or comprehensive EmNOC (CEmNOC) facilities using UN EmNOC signal functions. The required density of EmNOC facilities was calculated using UN norms. We also assessed the availability of EmNOC personnel, resuscitation equipment, drugs, fluids, and protocols at each facility. The workload of skilled EmNOC providers at hospitals and CHCs was compared.
resultsAll 7 hospitals in the district were classified as CEmNOC facilities, but none of the 8 CHCs performed all required signal functions to be classified as BEmNOC facilities. UN norms indicated that 25 EmNOC facilities were required for the district population, 5 of which should be CEmNOCs. None of the facilities had 100% of items on the EmNOC checklists. Hospital midwives delivered an average of 36.4±14.3 deliveries each per month compared to only 7.9±3.2 for CHC midwives (p<0.001).
conclusionsThe analysis indicated a shortfall of EmNOC facilities in the district. Full EmNOC services were centralised to hospitals to assure patient safety even though national policy guidelines sanction more decentralisation to CHCs. Studies measuring EmNOC availability need to consider facility opening hours, capacity and staffing in addition to the demonstrated performance of signal functions.
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