Quality of obstetric care in public-sector facilities and constraints to implementing emergency obstetric care services: evidence from high- and low-performing districts of Bangladesh.
This study explored the quality of obstetric care in public-sector facilities and the constraints to programming comprehensive essential obstetric care (EOC) services in rural areas of Khulna and Sylhet divisions, relatively high- and low-performing areas of Bangladesh respectively. Quality was expl...
| Published in: | Journal of Health, Population & Nutrition Vol. 27; no. 2; pp. 139 - 156 |
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| Main Authors: | , , , , , |
| Format: | research Journal Article |
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BioMed Central
Apr2009
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105347587&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105347587 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 16060997 HII jtl: Journal of Health, Population & Nutrition issn: 16060997 maglogo: N pubinfo: dt: Apr2009 vid: 27 iid: 2 pid: 24147 pub: BioMed Central artinfo: ui: 105347587 NLM19489412 2010304725 10.3329/jhpn.v27i2.3327 NLM19489412 105347587 ppf: 139 ppct: 17 formats: fmt: @attributes: type: P tig: atl: Quality of obstetric care in public-sector facilities and constraints to implementing emergency obstetric care services: evidence from high- and low-performing districts of Bangladesh. aug: au: Anwar I Kalim N Koblinsky M Anwar, Iqbal Kalim, Nahid Koblinsky, Marge affil: Public Health Sciences Division, ICDDR,B, G.P.O. Box 128, Dhaka 1000, Bangladesh sug: subj: Emergency Medical Services Standards Labor Complications Prevention and Control Obstetrics Standards Quality of Health Care Bangladesh Delivery, Obstetric Methods Delivery, Obstetric Standards Emergency Medical Services Administration Female Health and Welfare Planning Standards Health and Welfare Planning Labor Complications Mortality Maternal Health Services Administration Maternal Health Services Standards Maternal Mortality Obstetrics Pregnancy Public Sector Standards Human Female ab: This study explored the quality of obstetric care in public-sector facilities and the constraints to programming comprehensive essential obstetric care (EOC) services in rural areas of Khulna and Sylhet divisions, relatively high- and low-performing areas of Bangladesh respectively. Quality was explored by physically inspecting all public-sector EOC facilities and the constraints through in-depth interviews with public-sector programme managers and service providers. Distribution of the functional EOC facilities satisfied the United Nation's minimum criteria of at least one comprehensive EOC and four basic EOC facilities for every 500,000 people in Khulna but not in Sylhet region. Human-resource constraints were the major barrier for maternal health. Sanctioned posts for nurses were inadequate in rural areas of both the divisions; however, deployment and retention of trained human resources were more problematic in rural areas of Sylhet. Other problems also plagued care, including unavailability of blood in rural settings and lack of use of evidence-based techniques. The overall quality of care was better in the EOC facilities of Khulna division than in Sylhet. 'Context' of care was also different in these two areas: the population in Sylhet is less literate, more conservative, and faces more geographical and sociocultural barriers in accessing services. As a consequence of both care delivered and the context, more normal vaginal and caesarian-section deliveries were carried out in the public-sector EOC facilities in the Khulna region, with the exception of the medical college hospitals. To improve maternal healthcare, there is a need for a human-resource plan that increases the number of posts in rural areas and ensures availability. All categories of maternal healthcare providers also need training on evidence-based techniques. While the centralized push system of management has its strengths, special strategies for improving the response in the low-performing areas is urgently warranted. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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