Contribution of portable obstetric ultrasound service innovation in averting maternal and neonatal morbidities and mortalities at semi-urban health centers of Ethiopia: a retrospective facility-based study

Abstract

Background The maternal and neonatal mortalities in Ethiopia are high. To achieve the Sustainable Development Goals, innovations in ultrasound scanning and surveillance activities have been implemented at health centers for over 2 years. This study aims to estimate the contribution of obstetric ultrasound services on averted maternal and neonatal morbidities and mortalities in Ethiopia. Methods A retrospective facility-based cross-sectional study design was conducted in 25 selected health centers. Data were extracted from prenatal ultrasound registers. SPSS version 25 was used for analysis. To claim statistically significant relationship among sartorial variables, a chi-square test was analyzed and P < 0.05 was the cut-off point. Results Over the 2 years, 12,975 pregnant women were scanned and 52.8% of them were residing in rural areas. Abnormal ultrasound was reported in 12.7% and 98.4% of them were referred for confirmation of diagnosis and treatment. The ultrasound service has contributed to the prevention of 1,970 maternal and 19.05 neonatal morbidities and mortalities per 100,000 and 1,000 live births respectively. The averted morbidities and mortalities showed a statistically significant difference among women residing in rural and semi-urban areas, X,2 df (10) = 24.07, P = 0. 007 and X,2 df (5) = 20.87. P = 0.00, 1 respectively. Conclusion After availing the appropriate ultrasound machines with essential supplies and capacitating mid-level providers, significant number of high-risk pregnant women were identified on time and managed or referred to health facilities with safe delivery services. Therefore, scaling-up limited obstetric ultrasound services in similar setups will contribute to achieving the Sustainable Development Goals by 2030. It is recommended to enhance community awareness for improved utilization of ultrasound services by pregnant women before the 24th week of gestational age.

Effect of USAID-funded obstetric ultrasound service interventions on maternal and perinatal health outcomes at primary healthcare facilities in Ethiopia: a propensity score matching analysis

“…Consequently, the mother could use a better service to raise the well-being of her child. Despite of the fact that there are pieces of evidence that reported it does not have an effect on maternal or child health outcomes,33 34 obstetric ultrasound service resulted in a dimensional change to safe motherhood and better child well-being 24 35…”

Institutionalization of limited obstetric ultrasound leading to increased antenatal, skilled delivery, and postnatal service utilization in three regions of Ethiopia: A pre-post study

“…The results of this study reveal an increased and statistically significant difference in first and fourth ANC service utilization. Increased coverage of ANC with ultrasound scanning services at twelve weeks of pregnancy helps to identify high risk health conditions including congenital anomalies, ectopic pregnancies, and abortion [ 6 , 25 ]. In addition, ANC4 helps to determine other life-threatening conditions in women and neonates which includes mal-presentations, multiple fetuses, abnormalities in sizes of fetuses for gestational age, abnormal placentation, and antepartum hemorrhage [ 6 , 25 ].…”

“…Increased coverage of ANC with ultrasound scanning services at twelve weeks of pregnancy helps to identify high risk health conditions including congenital anomalies, ectopic pregnancies, and abortion [ 6 , 25 ]. In addition, ANC4 helps to determine other life-threatening conditions in women and neonates which includes mal-presentations, multiple fetuses, abnormalities in sizes of fetuses for gestational age, abnormal placentation, and antepartum hemorrhage [ 6 , 25 ]. Hence, providing comprehensive ANC services contributes to the reduction of preventable maternal and neonatal deaths.…”

“…Similarly, the institutionalization of limited obstetric ultrasound services at semi urban or rural health centers has increased utilization of SBA and PNC services at time of delivery and immediately after to forty five days. Increased SBA and PNC services improve diagnoses and management of post-partum hemorrhage and very low birthweight cases ultimately curbing deaths of mothers and neonates, respectively [ 25 ]. These findings are also in alignment with studies conducted in other settings.…”

“…Studies have documented improvements in maternal and neonatal health service utilization and favorable pregnancy outcomes for both mother and baby as well as improvements in quality of services in remote places around the world, as a result of availing obstetric point of care ultrasound services [13][14][15][16][17][18][19][20][21][22][23][24][25][26]. The United States Agency for International Development (USAID) Transform: Primary Health Care project institutionalized antenatal limited obstetric ultrasound services in 100 health centers in Ethiopia.…”