Emergency obstetric care availability: a critical assessment of the current indicator
Emergency obstetric care availability: a critical assessment of the current indicator
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DOI：
10.1111/j.1365-3156.2011.02851.x
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发表时间：
2012-01-01
影响因子：
3.3
通讯作者：
Campbell, Oona M. R.
中科院分区：
文献类型：
--
作者：
Gabrysch, Sabine;Zanger, Philipp;Campbell, Oona M. R.
监测在降低孕产妇和围产期死亡率方面取得的进展需要适当的指标。急诊产科护理(EMOC)设施的密度被提议作为一个潜在的有用指标，但不同的联合国文件提出了不一致的建议，而且它目前的表述与孕产妇死亡率无关。我们汇编了最近公布的指标基准，并区分了三个不一致的来源：(I)使用不同的分母衡量标准(按出生人口和按人口计算)，(Ii)对EMOC和EMOC设施的需求的不同假设，以及(Iii)未能具体说明设施能力(出生负荷)。与《2005年世界卫生报告》相比，联合国的指导方针和手册需要较少的EMOC设施，并且没有具体说明交付能力或人员配备水平。我们建议(I)始终使用出生率作为EMOC设施密度的分母，(Ii)明确说明需要基本和全面产科急救护理的分娩比例的假设，以及(Iii)指定设施的容量和人员配备，并根据不同人口密度的环境调整基准，以确保地理上的可达性。
Monitoring progress in reducing maternal and perinatal mortality requires suitable indicators. The density of emergency obstetric care (EmOC) facilities has been proposed as a potentially useful indicator, but different UN documents make inconsistent recommendations, and its current formulation is not associated with maternal mortality. We compiled recently published indicator benchmarks and distinguished three sources of inconsistency: (i) use of different denominator metrics (per birth and per population), (ii) different assumptions on need for EmOC and for EmOC facilities and (iii) failure to specify facility capacity (birth load). The UN guidelines and handbook require fewer EmOC facilities than the World Health Report 2005 and do not specify capacity for deliveries or staffing levels. We recommend (i) always using births as the denominator for EmOC facility density, (ii) clearly stating assumptions on the proportion of deliveries needing basic and comprehensive emergency obstetric care and the desired proportion of deliveries in EmOC facilities and (iii) specifying facility capacity and staffing and adapting benchmarks for settings with different population density to ensure geographical accessibility.