Service Availability and Readiness Assessment of Maternal, Newborn and Child Health Services at Public Health Facilities in Madagascar

Abstract

The Service Availability and Readiness Assessment (SARA) survey was adapted and used to generate information on service availability and the readiness of maternal, newborn and child health facilities to provide basic health care interventions for obstetric care, neonatal and child health in Madagascar. The survey collected data from fifty-two public health facilities, ranging from university hospitals (CHU), referral district and regional hospitals (CHD/ CHRR) to basic health centres (CSB). For basic emergency obstetric and newborn care (BEmONC) readiness, on average, CHU had nine (71.8%), CHD/CHRR had eight and CSB had six out of the thirteen tracer items. Regarding the availability of the eleven tracer items for comprehensive CEmONC services, on average a CHU had nine ( 80.0%), a CHRR had eight (71.1%) and a CHD that is the only type of hospitals in rural area had three tracer items (30.0%). Tracer item availability results are low, indicating the need to strengthen supplies at basic health centers in order to improve the chances of success of Madagascar's Roadmap for accelerating the reduction of the maternal and neonatal mortality 2015-2019, and meeting Sustainable Development Goals 3.1 and 3. (Afr J Reprod Health 2016 (Special Edition); 20[3]: 149-158).Keywords: Madagascar, Maternal and Child health services, Service availability and readiness assessment, Public health facilities Résumé L'Enquête sur la disponibilité du service et l'évaluation de l'état de préparation des services de santé´maternelle, néonatale et infantile (DSEP) a été adaptée et utilisée pour générer des informations sur la disponibilité du service et la disponibilité des établissements de santé maternelle, néonatale et infantile ' à assurer des interventions de soins de santé de base pour les soins obstétriques, la santé néonatale et infantile à Madagascar. L'enquête a recueilli des données à partir de cinquante-deux établissements de santé publique, couvrant des Centres hospitaliers universitaires (CHU), Centres d'orientation du District et les hôpitaux régionaux d'orientation (CHD / CHRR) aux centres de santé primaire(CSB). Pour les soins obstétricaux d'urgence de base et les soins du nouveau-né (SONUB) la préparation, en moyenne, CHU avait neuf (71,8%), CHD / CHRR avait huit et CSB avait six sur treize articles de traçage. En ce qui concerne la disponibilité des onze éléments traceurs pour les services SONUC complets, en moyenne, un CHU en avait neuf (80,0%), un CHRR en avait huit (71,1%) et qui est le seul type d'hôpitaux dans la région rurale avait trois éléments traceurs ( 30,0%) les résultats de la disponibilité des éléments traceurs sont faibles, ce qui indique la nécessité de renforcer l' approvisionnement des centres de santé primaire afin d'améliorer les possibilités de succès de la feuille de route de Madagascar pour accélérer la réduction de la mortalité maternelle et néonatale 2015-2019, et pour accomplir des objectifs de développement durable 3.1 et 3.2. (Afr J Reprod Health 2016 (Edition Spéciale); 20[3]: 149-158).

Health Facility Capacity to Provide Maternal and Newborn Healthcare Services in Unguja

“…Many health facilities do not offer all seven signal functions. This study finding also concurs with findings from other health facility surveys done in Tanzania, Uganda and Madagascar (Andriantsimietry et al, 2016;Bakari et al, 2015;MOHCDGEC, 2016;Wilunda et al, 2015).…”

“…Provision of healthcare services is crucial, it requires both physical presence of the services but also the quality and readiness of the services offered. This finding is consistent with other studies which showed that, readiness of ANC services was of average level, while trained staff, guidelines, equipment and supplies, diagnostics and medicines and commodities scored below average (Andriantsimietry et al, 2016;Olsen et al, 2005;Wilunda et al, 2015). Inadequate equipment and supplies have been reported to cause delays in patients to receive services, increased workload for staff, the need to source items from other facilities and causing unnecessary referral (Care et al, 2012;Mueenuddin & Msuya, 2012;Penfold et al, 2013).…”

“…Caesarean section was performed only in the tertiary hospital out of the three CEmONC facilities because of lack of doctors and anaesthetists in the special maternity hospital and PHCC. Similarly, in a study done in Madagascar a low coverage of CEmONC with only two out of nine regional referral hospitals providing the services (Andriantsimietry et al, 2016) Also the availability of blood supply was not sufficient across all CEmONC facilities which is similar to the previous study elsewhere (Andriantsimietry et al, 2016). Availability of blood is important in delivery services and is one of the reasons leading to maternal death.…”

Quality of Care for Maternal and Newborn Health in Health Facilities in Nepal

“…First, the facility needs to be adequately ready to provide care through infra-structure, equipment, drugs and human resource. Second, provision of the high-quality care requires implementation of set of quality improvement interventions (Andriantsimietry et al 2016, Kanyangarara et al 2017Ashish et al 2019).…”

Assessment of Family Planning Service Availability and Readiness in 10 African Countries

“…The SARA tool has been successfully used to generate a detailed assessment of the status of full health systems in such countries as Uganda 5 ; monitor and evaluate progress toward universal health coverage in South Africa 6 ; and assess availability and readiness of health facilities to provide general and specific services, such as chronic disease management in Uganda, 7 maternal and child health in Madagascar, 8 or family planning and child immunization in Burkina Faso, Cambodia, Haiti, Sierra Leone, and Tanzania. 4 The tool has also been valuable for making multi-country assessments and comparisons of reproductive, maternal, newborn, and child health to determine successful efforts toward meeting the Millennium Development Goals; 9 assessing surgical availability and readiness in Benin, Burkina Faso, the Democratic Republic of the Congo (the DRC), Mauritania, Sierra Leone, Togo, and Uganda 10 ; and achieving other research objectives.…”