Monitoring unmet obstetric need at district level in Morocco

Belghiti, Abdelali Alaoui; Brouwere, Vincent De; Kegels, Guy; Lerberghe, Wim Van

doi:10.1046/j.1365-3156.1998.00276.x

Cited by 32 publications

(36 citation statements)

References 24 publications

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“…AMIs reflect conditions that, without intervention, have a high probability of causing maternal death during childbirth or sequelae including the following (20):…”

Section: Fuelling the Information Vacuummentioning

confidence: 99%

Maternal Morbidity and Disability and Their Consequences: Neglected Agenda in Maternal Health

Koblinsky

Chowdhury

Moran

et al. 2012

J Health Popul Nutr

114

112

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“…AMIs reflect conditions that, without intervention, have a high probability of causing maternal death during childbirth or sequelae including the following (20):…”

Section: Fuelling the Information Vacuummentioning

confidence: 99%

Maternal Morbidity and Disability and Their Consequences: Neglected Agenda in Maternal Health

Koblinsky

Chowdhury

Moran

et al. 2012

J Health Popul Nutr

114

112

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“…Since we did not have MOI for AMI, RR for Tanzania we used a benchmark of 1 -2% as suggested in studies from Morocco 12 and Mali (1.2%) 13 . NB: The Moroccan study was the first of its kind to utilize the UON concept and the established reference ratio from this study was recommended to be used in other areas of similar characteristic where local reference ratio was not yet established.…”

Section: Unmet Obstetric Need (Uon)mentioning

confidence: 99%

“…Considering UON indicator and a reference ratio of 1-2% maternal mortality ratio for a population without access to any obstetric care 9 , 12 if major surgical interventions in a study area (usually C/ S) are below 1.0%, this would be regarded as an "unmet obstetric need". Conversely, major interventions in excess of 2.0% would indicate that operative deliveries are made on other indications than to avert maternal mortality.…”

Section: Unmet Obstetric Needmentioning

confidence: 99%

Are Process Indicators Adequate to Assess Essential Obstetric Care at District Level?: A Case Study from Rufiji District, Tanzania

Urassa¹,

Carlstedt²,

Nyström³

et al. 2005

African Journal of Reproductive Health

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To assess coverage and quality of essential obstetric care (EOC) and the appropriateness of using process indicators, a 3-month follow-up study was done in Rufiji district, Tanzania, involving 2 hospitals, 4 health centres, 10 large dispensaries and 10 randomly selected small dispensaries. Data collection was done on process indicators as suggested by UNICEF/ WHO/UNFPA (UN) and 'unmet obstetric need (UON) for major obstetric intervention (MOI)'. With standard values in (brackets), the district had two comprehensive EOC facilities, births in EOC amounted to 62% (15%), met need for EOC was 76% (100%), caesarean section (C/S) rate 4.1% (>5%), hospital case fatality rate (CFR) 1.0% (<1%) and successful obstetric referrals 46% (100%). MOI for absolute maternal indication in the district was 2.6% (1-2%). All four maternal deaths occurred due to transport failures. The process indicators gave contradictory impressions on the coverage and quality of care and failed to link to the outcome of delivery complications in the study. RÉSUMÉLes indicateurs du processus sont-ils adéquats pour évaluer le soin obstétrique essential au niveau du district? Une étude de cas du district de Rufiji, Tanzaniae Afin d'évaluer l'étendue et la qualité du soin obstétrique essentiel (SOE) et le caractère approprié de l'emploi des indicateurs de processus, une étude d'une durée de trois mois qui est basée sur des suivis médicaux, a été menée dans le district de Rufiji, Tanzanie, auprès de deux hôpitaux, quatre centres médicaux, diz grandes pharmacies et dix petites pharmacies selectionnées au hasard. Les données ont été recueillies à l'aide des indicateurs du processus comme l'ont préconisé l'UNICEF/OMS/UNFPA(ONU) et "le besoin obstétrique nonsatisfait (BON) à propos des interventions obstétriques principales (IOP)". Avec les valeurs normales (entre guillemets) le district disposait de deux structures de SOE, le taux de naissance par rapport au SOE s'est élevé à 62%(15%), le taux du besoin non-satisfait par rapport au SOE était de 76%(100%), le taux d'opération césarienne (OC) était de 4,1%(<5%), le taux du dècès des patients à l'hôpital (TDH) 1,0% (<1%) et les orientations vers les services spécialisés étaient de 46% (100%). L'IOP par rapport à l'indication maternelle absolue dans le district était de 2,6% (1-2%). Tous les quartre dècès maternels se sont produits à cause du manque de transport. Les indicateurs du processus ont signalé des impressions contradictoires en ce qui concerne la coverture et la qualité de soin et ils n'ont pas pu se lier au résultat des complications liées à l'accouchement dans l'étude. (Rev Afr Santé Reprod 2005; 9[3]:100-111) KEY WORDS: Quality of obstetric care, met needs, process indicators, program evaluation, Africa.

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“…The method has been used in several countries in Africa, Asia and the Caribbean (UON network 2004). Major deficits in obstetric interventions have been identified and UON study results have stimulated change of the maternal health policy (Belghiti et al. 1998; Quédraogo et al.…”

Section: Introductionmentioning

confidence: 99%

Assessing unmet obstetric need in Mtwara Region, Tanzania

Hunger¹,

Külker

Kitundu³

et al. 2007

Tropical Med Int Health

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Summaryobjective To evaluate maternity care, the feasibility of collecting the relevant data from hospital records, and to assess the usefulness for district health planning in the Mtwara Region, Tanzania.method A prospective study running over 2 years using the unmet obstetric need concept in all four hospitals in the region, covering all women undergoing major obstetric interventions. Data on indications, interventions, and pregnancy outcome were collected. Rates of major obstetric interventions performed for absolute maternal indications among all expected births in the study area were calculated to assess met and unmet need.results Of 2404 interventions, 91% were caesarean sections, most commonly indicated by cephalopelvic disproportion (46%). The rate of major obstetric intervention for absolute maternal indications per 100 expected births was 1.8% overall with wide rural-urban disparities (1.4% vs. 3.3%). Based on the estimated need of at least 2% of births requiring of a major obstetric intervention, seven of 20 divisions reached or surpassed this threshold, seven had a level between 1% and 2% and six did not reach 1%. Data were collected as part of the regular activities of the health staff, but external resources were needed for data management and analysis.conclusion We found a major unmet obstetric need in rural areas with a clear trend towards fewer interventions with longer distance from a hospital. Geographical mapping of the met obstetric need provided a detailed picture of deficiencies in the provision of maternity care and could be useful for priority setting and monitoring.keywords unmet obstetric need, unmet obstetric need indicator, process indicator, maternal mortality, district planning, Tanzania

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Monitoring unmet obstetric need at district level in Morocco

Cited by 32 publications

References 24 publications

Maternal Morbidity and Disability and Their Consequences: Neglected Agenda in Maternal Health

Maternal Morbidity and Disability and Their Consequences: Neglected Agenda in Maternal Health

Are Process Indicators Adequate to Assess Essential Obstetric Care at District Level?: A Case Study from Rufiji District, Tanzania

Assessing unmet obstetric need in Mtwara Region, Tanzania

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