Essential Obstetric Care: A Comprehensive Coverage Evaluation in Adansi-East District, Ghana.

Abstract

A.comprehensive coverage evaluation of essential obstetric care was carried out at the district referral point and the sub-districts’ first points of contact in the Adansi-East District, Ashanti Region. The evaluation tool consisted of measuring the coverage of essential care availability, access, utilization, adequacy and effectiveness. The essential care variables that were assessed were labour monitoring by partography, performance of obstetric surgery and the treatment of non-surgical obstetric complications. Interviews were conducted among district health managers, service providers, trained traditional birth attendants and women who delivered 12 months prior to the study, to identify factors causing bottlenecks in the coverage. The effectiveness coverage of each essential obstetric care variable was found to be very low, below 5%. This was mainly due to bottlenecks at resource availability and service utilization at the district and sub-district levels. There was also a bottleneck at access coverage at the district level for all the variables. The low availability coverage was due to lack of ..: . information and training in the use of essential care resources, absence of resident midwives and lack of rooms to treat cases. The low utilization was as a result of the inability of the facilities to effectively treat obstetric complications. Most women with obstetric complications therefore use facilities outside the district. To improve the effectiveness coverage of essential obstetric care, it is recommended that the District Health Team reallocates midwives, ensures the provision of a minimal package of essential resources in each facility, provides life-saving skills training for essential care providers and strengthens its collaboration with the communities.