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The theme for the world health day (7th April 1998) was safemotherhood initiative Goal cut maternal mortality by 50% by year 2000 Inspite of the achievement in maternal health, a staggering 585,000 maternal death still occurs annually. Almost 90% occurring in Sub-saharan Africa and Asia and less than 10% in the developed countries Difference in maternal mortality ratios in developed and developing countries is staggering ranging from 100-1000 deaths per 100,000 livebirths in poor resource countries, compared to 8-15 per 100,000 livebirths in the developed countries
Most of these are preventable, however, due to the difficulty in predicting with certainty in advance their occurrence hence the need for measures to prevent them or reduce the consequences.
Primary prevention measures for some of the complications are not yet known
Secondary prevention is possible in all cases especially following early detection; transport and presence of health personnel with necessary skill and resources
Two interventions strategies have been proposed
Essential obstetric care Emergency obstetric care
Levels of EOC
Health post level provision of obstetric first aid ergometrine, antibiotics, sedatives, and possibly vacuum aspiration for incomplete abortion
Health centre level (basic EOC) one or more trained worker(s) and equipment: oxytocics, antibiotics, manual placental removal, assisted delivery, MVA for incomplete abortion
Medical management of sepsis, shock, anaemia and eclampsia, blood transfusion, management for hypothermia
AIM of EOC
To accelerate country-level action to improve maternal health by focusing on preventing, detecting and managing the major causes of maternal mortality
Process indicator series provides information about EOC coverage (availability, accessibility and utilization) as well as the performance of EOC facilities.
EOC coverage
For Quality care there should be one facility for comprehensive EOC and 4 facilities providing basic EOC for every 500,000 people. These should exist within an acceptable geographical area A minimum of 15% of all birth in the population should take place in EOC facility
Met Need for EOC 100% of all women with obstetric complications should be treated in basic or comprehensive EOC A minimum of 15% of all birth in the population should take place in EOC facilities
conclusion
Thank you for listening