Status of emergency obstetric care in four districts of Punjab, Pakistan - results of a baseline assessment

Objective: To assess the availability and quality of Emergency Obstetric and Newborn Care in four districts of Punjab. Methods: The cross-sectional descriptive study was conducted in Attock, Gujranwala, Rahim Yar Khan and Khanewal districts of Pakistan's Punjab province. Data was collected in July 2012 from all District Headquarter Hospitals, Tehsil Headquarter Hospitals and selective Rural Health Centres (RHCs) using a pre-formatted questionnaire to assess availability of signal functions of Emergency Obstetric and Newborn Care, including staffing and equipment, number of births and women with complications, maternal case fatality rate and stillbirth rate. SPSS 20 was used for statistical analysis. Results: In total, 32 health care facilities were surveyed: 14(43.75%) providing basic care and, 18(56.25) providing comprehensive obstetric care. All required signal functions were available at 4(22%) in the latter category, and 3(21%) facilities in the former category. Met need for Emergency Obstetric and Newborn Care was 17.8%. Besides, there were 26 maternal deaths among the 1,482 women with recognised obstetric complications, indicating an overall case fatality rate for all districts of 1.75%. Conclusion: Continued efforts are needed to improve the availability and quality of Emergency Obstetric and Newborn Care through targeted skill-based training and provision of adequate drugs and equipment.