Emergency Obstetric Care in the Prevention of Maternal Mortality

By Professor A. U. Oronsaye; FWACS

Introduction : Definition &Scope of the Subject
• The prevention of maternal deaths is an area in which no amount of primary health care or community effort can make a significant impact unless it is built around adequate medial services. (Rosenfiled and Maurine 1985)

Introduction contd
• Once pregnant, probably 15-20% will develop serious complication such as obstructed labour, placental abnormalities , preclampsia, irrespective of medical care received of social status (Hibbard; 1978, Hartfield 1980)

Concept of Emergency Obstetric Care (EmOC)
• About two decades ago, WHO concluded from several studies by experts under its auspices that of all health interventions, the single most important factor in the prevention of maternal mortality is the concept of Emergency Obstetric Care (EmOC) (WHO, 1986 page 10)

Suggestive options and strategies
1. Upgrade small Rural Hospital Health Centers b. Have a resident physician with Basic Surgical Obstetric skill c. Provide facilities for carrying out simple obstetrics surgical procedures such as manual removal of placenta d. Provide facilities for basic urine tests, packed Cell Volume (PCV) etc. e. Provide blood transfusion facilities

Suggestive options and strategies contd.
2. Training /retraining of middle level health providers - Effective use of Non-Specialists to manage complications at the Primary or Rural Health Services

Suggestion options and strategy contd.
3. Provision of Drugs and Equipment for Emergency Obstetric Care • At the Primary or Basic Level provision and Obstetric First-Aid box and essential drugs and supplies may be all that is required at the primary Health Centres • At the Secondary and Tertiary Levels, there is room for Organisational improvement - Effective 24 hours coverage - Emergency obstetric care financing - Abolition/Reduction of stage III delay. That i.e. delay in receiving adequate care at the institution or facility.

Conclusion
• Impact of effective and efficient Emergency Obstetric Care (EmOC) as part and parcel of the strategy of safe motherhood in reducing maternal deaths in the practice can not be over emphasized. • Neglect of this aspect of the strategy is continued escalation or at the best is a stats and the prevention of maternal mortality.

Thank you All

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