In:
Obstetrics & Gynecology, Ovid Technologies (Wolters Kluwer Health), Vol. 129, No. 1 ( 2017-05), p. 81S-81S
Abstract:
Preventing maternal and neonatal morbidity and mortality in health care facilities depends heavily on the provision of emergency obstetric care (EmOC). A dominant framework for assessing EmOC capacity focuses on the presence of tracer items (e.g. antibiotics, MgSO4) for signal functions (e.g. sepsis treatment, management of preeclampsia). Our study aims to assess the feasibility of a novel capacity cascades framework to measure facility EmOC readiness and to compare it with the known signal function framework. METHODS: The capacity cascades framework is characterized by three stages of EmOC readiness: 1) identification of emergency, 2) treatment, 3) monitoring and modification of treatment. Retrospective facility inventory data were obtained from 36 Guatemalan basic EmOC facilities. Mapping of the capacity cascades and signal function framework variables was done using STATA12 for: hemorrhage, hypertensive emergency, retained placenta, sepsis. Proportion of facilities meeting criteria for readiness based on each cascade stage and signal function was calculated. RESULTS: For hemorrhage EmOC readiness, 75.0% of facilities met signal function criteria versus 97.2% capacity cascade stage 1; 75.0% stage 2; 33.3% stage 3. For hypertensive emergency, 86.1% versus 97.2%; 77.8%; 38.9%. For retained placenta, 75.0% versus 97.2%; 52.8%; 13.9%. For sepsis, 100% versus 100%; 75%; 33.3%. CONCLUSION: This study shows that capacity cascade framework is easy to apply and demonstrates a discrepancy from the signal function framework that suggests an overestimate of EmOC readiness by the latter. An early study in Kenya showed similar trends, demonstrating reproducibility. Further work needs to be done investigating association with clinical outcomes to determine clinical relevance.
Type of Medium:
Online Resource
ISSN:
0029-7844
DOI:
10.1097/01.AOG.0000515617.25345.c6
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2017
detail.hit.zdb_id:
2012791-1
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