Correlation of Obstetric Care Facility Density with Standard Emergency Obstetric and Neonatal Care Indicators in Tanzania Mainland

Projestine Muganyizi; Edward Maswanya; Stella Kilima; Grades Stanley; Julius Massaga; Victor Bakengesa

doi:doi:10.11648/j.jgo.20170505.12

| Peer-Reviewed

Correlation of Obstetric Care Facility Density with Standard Emergency Obstetric and Neonatal Care Indicators in Tanzania Mainland

Projestine Muganyizi, Edward Maswanya, Stella Kilima, Grades Stanley, Julius Massaga, Victor Bakengesa

Published in Journal of Gynecology and Obstetrics (Volume 5, Issue 5)

Received: 31 July 2017 Accepted: 15 August 2017 Published: 6 September 2017

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Tanzania’s Primary Health Services Development Program (PHSDP) started in 2007 with the aim to establish and staff an additional 5162 dispensaries, 2074 health centres and 8 district hospitals by 2017 which would implicitly increase obstetric care facility density. However, currently obstetric care facility density is not a standard Emergency Obstetric and Neonatal Care (EmONC) indicator and data on its correlation with the standard EmONC indicators is scanty. In 2015 a cross-sectional survey of all hospitals, health centres and a random sample of dispensaries providing delivery services in all the 25 regions of Tanzania Mainland was conducted whereby the presence of EmONC functions in past 3 months was assessed using a standard tool. Where necessary, population data were based on the 2012 National housing and population Census and the 2010 Tanzania Demographic Health Survey (TDHS). Data were analyzed using IBM SPSS version 20 and STATA. Spatial Mapping was done using a calibrated Geographic Positioning System (GPS) Essential Software for Android and coordinates represented on digitalized map with Arc Geographic Information System (GIS). Ethical approval was granted by the Ethical Clearance Committee of Medical Research Council [MRCC], National Institute for Medical research. Of the confirmed 5207 obstetric care facilities 2405 (46.2%) were surveyed including 35.3% of all dispensaries. National Obstetric care facility density was 68/ 500,000 population, 7/500,000 of them provided all the 7 Basic Emergency Obstretic and Neonatal Care (BEmONC) functions in past 3 months. Among all the regions, 40% had attained or exceeded the international benchmark for EmONC facilities per 500,000 population. Institutional delivery rate was 79% and overall Caesarean Section rate was 5.6%. Improved obstetric care facility density was strongly correlated with improved institutional delivery; Caesarean section rate and met need for EmONC but not the quality of case management. In conclusion obstetric care facility density is well correlated with other standard EmONC indicators.

Published in	Journal of Gynecology and Obstetrics (Volume 5, Issue 5)
DOI	10.11648/j.jgo.20170505.12
Page(s)	60-68
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Emergency Obstetric Care, Neonatal Care, Obstetric Care Facility Density, Indicator, Correlation, Tanzania

References

[1]	Paxton A, Maine D, Freedman L, Fry D, Lobis S: The evidence for emergency obstetric care. Int J Gynaecol Obstet 2005; 88(2):181-193.
[2]	AMDD: Averting Maternal Death and Disability Program (AMDD). Needs Assessment of Emergency Obstetric and Newborn Care (EmONC): Facilita tor's Guide. In. Edited by AMDD. New York: Columbia University; 2009.
[3]	Bosomprah S, Tatem AJ, Dotse-Gborgbortsi W, Aboagye P, Matthews Z: Spatial distribution of emergency obstetric and newborn care services in Ghana: Using the evidence to plan interventions. Int J Gynaecol Obstet 2016; 132(1):130-134.
[4]	Kongnyuy EJ, Hofman J, Mlava G, Mhango C, van den Broek N: Availability, utilisation and quality of basic and comprehensive emergency obstetric care services in Malawi. Matern Child Health J 2009; 13(5):687-694.
[5]	Ng’anjo PS, Fylkesnes K, Moland KM, Byskov J, Kiserud T: Rural-Urban Inequity in Unmet Obstetric Needs and Functionality of Emergency Obstetric Care Services in a Zambian District. PLoS ONE Editor: Hamid Reza Baradaran, Iran University of 2016, 11(1).
[6]	Otolorin E, Gomez P, Currie S, Thapa K, Dao B: Essential basic and emergency obstetric and newborn care: from education and training to service delivery and quality of care. Int J Gynaecol Obstet 2015; 130 Suppl 2:S46-53.
[7]	Pattinson RC, Makin JD, Pillay Y, Van den Broek N, Moodley J: Basic and comprehensive emergency obstetric and neonatal care in 12 South African health districts. S Afr Med J 2015; 105(4):256-260.
[8]	Utz B, Zafar S, Arshad N, Kana T, Gopalakrishnan S: Status of emergency obstetric care in four districts of Punjab, Pakistan - results of a baseline assessment. J Pak Med Assoc 2015; 65(5):480-485.
[9]	Holmer H, Oyerinde K, Meara JG, Gillies R, Liljestrand J, Hagander L: The global met need for emergency obstetric care: a systematic review. Bjog 2015; 122(2):183-189.
[10]	WHO: Monitoring Emergency Obstetric Care: A Handbook. Geneva: World Health Organization; 2009.
[11]	Abegunde D, Kabo IA, Sambisa W, Akomolafe T, Orobaton N, Abdulkarim M, Sadauki H: Availability, utilization, and quality of emergency obstetric care services in Bauchi State, Nigeria. Int J Gynaecol Obstet 2015; 128(3):251-255.
[12]	Ansari MS, Manzoor R, Siddiqui N, Ahmed AM: Access to comprehensive emergency obstetric and newborn care facilities in three rural districts of Sindh province, Pakistan. Health Res Policy Syst 2015; 13 Suppl 1:55.
[13]	Chi PC, Bulage P, Urdal H, Sundby J: Barriers in the Delivery of Emergency Obstetric and Neonatal Care in Post-Conflict Africa: Qualitative Case Studies of Burundi and Northern Uganda. PLoS One 2015; 10(9):e0139120.
[14]	MOHSW: Human Resource for Health and Social Welfare Strategic Plan 2014 - 2019. In. Edited by Welfare MOHSW. Dar es Salaam: Ministry of Health and Social Welfare; 2014.
[15]	Schneeberger C, Mathai M: Emergency obstetric care: Making the impossible possible through task shifting. Int J Gynaecol Obstet 2015; 131 Suppl 1:S6-9.
[16]	Sikder SS, Labrique AB, Ali H, Hanif AA, Klemm RD, Mehra S, West KP, Jr., Christian P: Availability of emergency obstetric care (EmOC) among public and private health facilities in rural northwest Bangladesh. BMC Public Health 2015; 15:36.
[17]	Ueno E, Adegoke AA, Masenga G, Fimbo J, Msuya SE: Skilled birth attendants in Tanzania: a descriptive study of cadres and emergency obstetric care signal functions performed. Matern Child Health J 2015; 19(1):155-169.
[18]	Vora KS, Yasobant S, Patel A, Upadhyay A, Mavalankar DV: Has Chiranjeevi Yojana changed the geographic availability of free comprehensive emergency obstetric care services in Gujarat, India? Glob Health Action 2015; 8:28977.
[19]	Khan KS, Wojdyla D, Say L, Gulmezoglu AM, Van Look PF: WHO analysis of causes of maternal death: a systematic review. Lancet 2006; 367(9516):1066-1074.
[20]	WHO, UNICEF: Countdown to 2015 Decade Report (2000–2010): Taking Stock of Maternal, Newborn and Child Survival. In. Geneva: World Health Organization; 2010.
[21]	Cohen J: Statistical power analysis for the behavioral sciences, 2^nd edn. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.
[22]	Fakih B, Nofly AA, Ali AO, Mkopi A, Hassan A, Ali AM, Ramsey K, Kabuteni TJ, Mbaruku G, Mrisho M: The status of maternal and newborn health care services in Zanzibar. BMC Pregnancy Childbirth 2016; 16(1):134.
[23]	Eniola A. Bamgboye EA, Akindele O. Adebiyi, A. O., Fatiregun, A. A.: Assessment of Emergency Obstetric Care Services in Ibadan-Ibarapa Health Zone, Oyo State, Nigeria. African Journal of Reproductive Health 2016; 20(1):88-97.
[24]	Gabrysch S, Simushi V, Campbell OM: Availability and distribution of, and geographic access to emergency obstetric care in Zambia. Int J Gynaecol Obstet 2011; 114(2):174-179.
[25]	Kim YM, Zainullah P, Mungia J, Tappis H, Bartlett L, Zaka N: Availability and quality of emergency obstetric and neonatal care services in Afghanistan. Int J Gynaecol Obstet 2012, 116(3):192-196.
[26]	Olsen OE, Ndeki S, Norheim OF: Availability, distribution and use of emergency obstetric care in northern Tanzania. Health Policy Plan 2005; 20(3):167-175.
[27]	Paxton A, Bailey P, Lobis S, Fry D: Global patterns in availability of emergency obstetric care. Int J Gynaecol Obstet 2006; 93(3):300-307.
[28]	MOHSW: The National Road Map Strategic Plan to Improve Reproductive, Maternal, Newborn, Child & Adolescent Health in Tanzania (2016 - 2020). In: One Plan II. Dar es Salaam; 2015.
[29]	Yasobant S, Vora KS, Shewade HD, Annerstedt KS, Isaakidis P, Mavalankar DV, Dholakia NB, De Costa A: Utilization of the state led public private partnership program "Chiranjeevi Yojana" to promote facility births in Gujarat, India: a cross sectional community based study. BMC Health Serv Res 2016; 16:266.
[30]	Saxena D, Vangani R, Mavalankar DV, Thomsen S: Inequity in maternal health care service utilization in Gujarat: analyses of district-level health survey data. Glob Health Action 2013; 6:1-9.
[31]	Bennett TA, Kotelchuck M, Cox CE, Tucker MJ, Nadeau DA: Pregnancy-associated hospitalizations in the United States in 1991 and 1992: a comprehensive view of maternal morbidity. Am J Obstet Gynecol 1998; 178(2):346-354.
[32]	Bang RA, Bang AT, Reddy MH, Deshmukh MD, Baitule SB, Filippi V: Maternal morbidity during labour and the puerperium in rural homes and the need for medical attention: A prospective observational study in Gadchiroli, India. Bjog 2004; 111(3):231-238.
[33]	McCord C, Premkumar R, Arole S, Arole R: Efficient and effective emergency obstetric care in a rural Indian community where most deliveries are at home. Int J Gynaecol Obstet 2001; 75(3):297-307; discussion 308-299.
[34]	Ronsmans C, Campbell OM, McDermott J, Koblinsky M: Questioning the indicators of need for obstetric care. Bull World Health Organ 2002; 80(4):317-324.
[35]	Paxton A, Bailey P, Lobis S: The United Nations Process Indicators for emergency obstetric care: Reflections based on a decade of experience. Int J Gynaecol Obstet 2006; 95(2):192-208.

Cite This Article

Plain Text BibTeX RIS

APA Style

Projestine Muganyizi, Edward Maswanya, Stella Kilima, Grades Stanley, Julius Massaga, et al. (2017). Correlation of Obstetric Care Facility Density with Standard Emergency Obstetric and Neonatal Care Indicators in Tanzania Mainland. Journal of Gynecology and Obstetrics, 5(5), 60-68. https://doi.org/10.11648/j.jgo.20170505.12

Copy | Download

ACS Style

Projestine Muganyizi; Edward Maswanya; Stella Kilima; Grades Stanley; Julius Massaga, et al. Correlation of Obstetric Care Facility Density with Standard Emergency Obstetric and Neonatal Care Indicators in Tanzania Mainland. J. Gynecol. Obstet. 2017, 5(5), 60-68. doi: 10.11648/j.jgo.20170505.12

Copy | Download

AMA Style

Projestine Muganyizi, Edward Maswanya, Stella Kilima, Grades Stanley, Julius Massaga, et al. Correlation of Obstetric Care Facility Density with Standard Emergency Obstetric and Neonatal Care Indicators in Tanzania Mainland. J Gynecol Obstet. 2017;5(5):60-68. doi: 10.11648/j.jgo.20170505.12

Copy | Download

@article{10.11648/j.jgo.20170505.12,
  author = {Projestine Muganyizi and Edward Maswanya and Stella Kilima and Grades Stanley and Julius Massaga and Victor Bakengesa},
  title = {Correlation of Obstetric Care Facility Density with Standard Emergency Obstetric and Neonatal Care Indicators in Tanzania Mainland},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {5},
  number = {5},
  pages = {60-68},
  doi = {10.11648/j.jgo.20170505.12},
  url = {https://doi.org/10.11648/j.jgo.20170505.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20170505.12},
  abstract = {Tanzania’s Primary Health Services Development Program (PHSDP) started in 2007 with the aim to establish and staff an additional 5162 dispensaries, 2074 health centres and 8 district hospitals by 2017 which would implicitly increase obstetric care facility density. However, currently obstetric care facility density is not a standard Emergency Obstetric and Neonatal Care (EmONC) indicator and data on its correlation with the standard EmONC indicators is scanty. In 2015 a cross-sectional survey of all hospitals, health centres and a random sample of dispensaries providing delivery services in all the 25 regions of Tanzania Mainland was conducted whereby the presence of EmONC functions in past 3 months was assessed using a standard tool. Where necessary, population data were based on the 2012 National housing and population Census and the 2010 Tanzania Demographic Health Survey (TDHS). Data were analyzed using IBM SPSS version 20 and STATA. Spatial Mapping was done using a calibrated Geographic Positioning System (GPS) Essential Software for Android and coordinates represented on digitalized map with Arc Geographic Information System (GIS). Ethical approval was granted by the Ethical Clearance Committee of Medical Research Council [MRCC], National Institute for Medical research. Of the confirmed 5207 obstetric care facilities 2405 (46.2%) were surveyed including 35.3% of all dispensaries. National Obstetric care facility density was 68/ 500,000 population, 7/500,000 of them provided all the 7 Basic Emergency Obstretic and Neonatal Care (BEmONC) functions in past 3 months. Among all the regions, 40% had attained or exceeded the international benchmark for EmONC facilities per 500,000 population. Institutional delivery rate was 79% and overall Caesarean Section rate was 5.6%. Improved obstetric care facility density was strongly correlated with improved institutional delivery; Caesarean section rate and met need for EmONC but not the quality of case management. In conclusion obstetric care facility density is well correlated with other standard EmONC indicators.},
 year = {2017}
}

Copy | Download

TY  - JOUR
T1  - Correlation of Obstetric Care Facility Density with Standard Emergency Obstetric and Neonatal Care Indicators in Tanzania Mainland
AU  - Projestine Muganyizi
AU  - Edward Maswanya
AU  - Stella Kilima
AU  - Grades Stanley
AU  - Julius Massaga
AU  - Victor Bakengesa
Y1  - 2017/09/06
PY  - 2017
N1  - https://doi.org/10.11648/j.jgo.20170505.12
DO  - 10.11648/j.jgo.20170505.12
T2  - Journal of Gynecology and Obstetrics
JF  - Journal of Gynecology and Obstetrics
JO  - Journal of Gynecology and Obstetrics
SP  - 60
EP  - 68
PB  - Science Publishing Group
SN  - 2376-7820
UR  - https://doi.org/10.11648/j.jgo.20170505.12
AB  - Tanzania’s Primary Health Services Development Program (PHSDP) started in 2007 with the aim to establish and staff an additional 5162 dispensaries, 2074 health centres and 8 district hospitals by 2017 which would implicitly increase obstetric care facility density. However, currently obstetric care facility density is not a standard Emergency Obstetric and Neonatal Care (EmONC) indicator and data on its correlation with the standard EmONC indicators is scanty. In 2015 a cross-sectional survey of all hospitals, health centres and a random sample of dispensaries providing delivery services in all the 25 regions of Tanzania Mainland was conducted whereby the presence of EmONC functions in past 3 months was assessed using a standard tool. Where necessary, population data were based on the 2012 National housing and population Census and the 2010 Tanzania Demographic Health Survey (TDHS). Data were analyzed using IBM SPSS version 20 and STATA. Spatial Mapping was done using a calibrated Geographic Positioning System (GPS) Essential Software for Android and coordinates represented on digitalized map with Arc Geographic Information System (GIS). Ethical approval was granted by the Ethical Clearance Committee of Medical Research Council [MRCC], National Institute for Medical research. Of the confirmed 5207 obstetric care facilities 2405 (46.2%) were surveyed including 35.3% of all dispensaries. National Obstetric care facility density was 68/ 500,000 population, 7/500,000 of them provided all the 7 Basic Emergency Obstretic and Neonatal Care (BEmONC) functions in past 3 months. Among all the regions, 40% had attained or exceeded the international benchmark for EmONC facilities per 500,000 population. Institutional delivery rate was 79% and overall Caesarean Section rate was 5.6%. Improved obstetric care facility density was strongly correlated with improved institutional delivery; Caesarean section rate and met need for EmONC but not the quality of case management. In conclusion obstetric care facility density is well correlated with other standard EmONC indicators.
VL  - 5
IS  - 5
ER  -

Copy | Download

Author Information

Projestine Muganyizi

Department of Obstetrics and Gynecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
Edward Maswanya

National Institute for Medical Research, Dar es Salaam, Tanzania
Stella Kilima

National Institute for Medical Research, Dar es Salaam, Tanzania
Grades Stanley

National Institute for Medical Research, Dar es Salaam, Tanzania
Julius Massaga

National Institute for Medical Research, Dar es Salaam, Tanzania
Victor Bakengesa

Ministry of Health Community Development Gender Elderly and Children, Dar es Salaam, Tanzania

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Projestine Muganyizi, Edward Maswanya, Stella Kilima, Grades Stanley, Julius Massaga, et al. (2017). Correlation of Obstetric Care Facility Density with Standard Emergency Obstetric and Neonatal Care Indicators in Tanzania Mainland. Journal of Gynecology and Obstetrics, 5(5), 60-68. https://doi.org/10.11648/j.jgo.20170505.12

Copy | Download

ACS Style

Projestine Muganyizi; Edward Maswanya; Stella Kilima; Grades Stanley; Julius Massaga, et al. Correlation of Obstetric Care Facility Density with Standard Emergency Obstetric and Neonatal Care Indicators in Tanzania Mainland. J. Gynecol. Obstet. 2017, 5(5), 60-68. doi: 10.11648/j.jgo.20170505.12

Copy | Download

AMA Style

Projestine Muganyizi, Edward Maswanya, Stella Kilima, Grades Stanley, Julius Massaga, et al. Correlation of Obstetric Care Facility Density with Standard Emergency Obstetric and Neonatal Care Indicators in Tanzania Mainland. J Gynecol Obstet. 2017;5(5):60-68. doi: 10.11648/j.jgo.20170505.12

Copy | Download

@article{10.11648/j.jgo.20170505.12,
  author = {Projestine Muganyizi and Edward Maswanya and Stella Kilima and Grades Stanley and Julius Massaga and Victor Bakengesa},
  title = {Correlation of Obstetric Care Facility Density with Standard Emergency Obstetric and Neonatal Care Indicators in Tanzania Mainland},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {5},
  number = {5},
  pages = {60-68},
  doi = {10.11648/j.jgo.20170505.12},
  url = {https://doi.org/10.11648/j.jgo.20170505.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20170505.12},
  abstract = {Tanzania’s Primary Health Services Development Program (PHSDP) started in 2007 with the aim to establish and staff an additional 5162 dispensaries, 2074 health centres and 8 district hospitals by 2017 which would implicitly increase obstetric care facility density. However, currently obstetric care facility density is not a standard Emergency Obstetric and Neonatal Care (EmONC) indicator and data on its correlation with the standard EmONC indicators is scanty. In 2015 a cross-sectional survey of all hospitals, health centres and a random sample of dispensaries providing delivery services in all the 25 regions of Tanzania Mainland was conducted whereby the presence of EmONC functions in past 3 months was assessed using a standard tool. Where necessary, population data were based on the 2012 National housing and population Census and the 2010 Tanzania Demographic Health Survey (TDHS). Data were analyzed using IBM SPSS version 20 and STATA. Spatial Mapping was done using a calibrated Geographic Positioning System (GPS) Essential Software for Android and coordinates represented on digitalized map with Arc Geographic Information System (GIS). Ethical approval was granted by the Ethical Clearance Committee of Medical Research Council [MRCC], National Institute for Medical research. Of the confirmed 5207 obstetric care facilities 2405 (46.2%) were surveyed including 35.3% of all dispensaries. National Obstetric care facility density was 68/ 500,000 population, 7/500,000 of them provided all the 7 Basic Emergency Obstretic and Neonatal Care (BEmONC) functions in past 3 months. Among all the regions, 40% had attained or exceeded the international benchmark for EmONC facilities per 500,000 population. Institutional delivery rate was 79% and overall Caesarean Section rate was 5.6%. Improved obstetric care facility density was strongly correlated with improved institutional delivery; Caesarean section rate and met need for EmONC but not the quality of case management. In conclusion obstetric care facility density is well correlated with other standard EmONC indicators.},
 year = {2017}
}

Copy | Download

TY  - JOUR
T1  - Correlation of Obstetric Care Facility Density with Standard Emergency Obstetric and Neonatal Care Indicators in Tanzania Mainland
AU  - Projestine Muganyizi
AU  - Edward Maswanya
AU  - Stella Kilima
AU  - Grades Stanley
AU  - Julius Massaga
AU  - Victor Bakengesa
Y1  - 2017/09/06
PY  - 2017
N1  - https://doi.org/10.11648/j.jgo.20170505.12
DO  - 10.11648/j.jgo.20170505.12
T2  - Journal of Gynecology and Obstetrics
JF  - Journal of Gynecology and Obstetrics
JO  - Journal of Gynecology and Obstetrics
SP  - 60
EP  - 68
PB  - Science Publishing Group
SN  - 2376-7820
UR  - https://doi.org/10.11648/j.jgo.20170505.12
AB  - Tanzania’s Primary Health Services Development Program (PHSDP) started in 2007 with the aim to establish and staff an additional 5162 dispensaries, 2074 health centres and 8 district hospitals by 2017 which would implicitly increase obstetric care facility density. However, currently obstetric care facility density is not a standard Emergency Obstetric and Neonatal Care (EmONC) indicator and data on its correlation with the standard EmONC indicators is scanty. In 2015 a cross-sectional survey of all hospitals, health centres and a random sample of dispensaries providing delivery services in all the 25 regions of Tanzania Mainland was conducted whereby the presence of EmONC functions in past 3 months was assessed using a standard tool. Where necessary, population data were based on the 2012 National housing and population Census and the 2010 Tanzania Demographic Health Survey (TDHS). Data were analyzed using IBM SPSS version 20 and STATA. Spatial Mapping was done using a calibrated Geographic Positioning System (GPS) Essential Software for Android and coordinates represented on digitalized map with Arc Geographic Information System (GIS). Ethical approval was granted by the Ethical Clearance Committee of Medical Research Council [MRCC], National Institute for Medical research. Of the confirmed 5207 obstetric care facilities 2405 (46.2%) were surveyed including 35.3% of all dispensaries. National Obstetric care facility density was 68/ 500,000 population, 7/500,000 of them provided all the 7 Basic Emergency Obstretic and Neonatal Care (BEmONC) functions in past 3 months. Among all the regions, 40% had attained or exceeded the international benchmark for EmONC facilities per 500,000 population. Institutional delivery rate was 79% and overall Caesarean Section rate was 5.6%. Improved obstetric care facility density was strongly correlated with improved institutional delivery; Caesarean section rate and met need for EmONC but not the quality of case management. In conclusion obstetric care facility density is well correlated with other standard EmONC indicators.
VL  - 5
IS  - 5
ER  -

Copy | Download