Reducing maternal mortality in Mozambique:: challenges, failures, successes and lessons learned
Reducing maternal mortality in Mozambique:: challenges, failures, successes and lessons learned
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DOI：
10.1016/j.ijgo.2004.01.005
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发表时间：
2004-05-01
影响因子：
3.8
通讯作者：
Faúndes, A
中科院分区：
文献类型：
--
作者：
Jamisse, L;Songane, F;Faúndes, A
本文的目的是描述使莫桑比克妇女能够获得紧急产科护理(EMOC)的不同方法。联合国各机构提出的基本(BEMOC)和综合EMOC(CEMOC)的定义被莫桑比克卫生部和菲律宾政府采纳，作为降低产妇死亡率的总体战略。介绍了四个项目：(1)Jose Macamo和(2)马普托市的Mavalane医院，(3)马普托省的Manhica区，(4)索法拉省。何塞·马卡诺的工作人员是一天24小时工作的医生；其他医院的工作人员是受过外科和麻醉学技术培训的非医生，以及护士-助产士。何塞·马卡莫医院为马普托市和马普托省南部地区提供了CEMOC。2001年，该院接诊了该市32%的分娩和38%的剖腹产，高于1998年的14%和2.5%。Mavalane医院未能提供CEMOC；然而，每年的分娩数量几乎翻了一番。2001年，Manhica医院进行了该地区31%的剖腹产，高于1998年的9%。在索法拉省，又安装了一个CEMOC和四个BEMOC，病死率有所下降。总而言之，确保提供EMOC的战略是可行的，即使在莫桑比克等资源最少和医生稀缺的国家也是如此。(C)2004年国际妇产科联合会。爱思唯尔爱尔兰有限公司出版。版权所有。
The aim of this paper is to describe different approaches to make emergency obstetric care (EmOC) accessible to women in Mozambique. The definitions of basic (BEmOC) and comprehensive EmOC (CEmOC), proposed by the UN agencies, were adopted by FIGO and by the Mozambican Ministry of Health as a general strategy to reduce maternal mortality. Four projects are presented: (1) Jose Macamo and (2) Mavalane Hospitals in Maputo city, (3) Manhica District in Maputo Province and (4) Sofala Province. Jose Macarno was staffed by physicians 24 h a day; other hospitals by non-physicians trained in surgical and anesthesiology techniques, as well as nurse-midwives. Jose Macamo Hospital provided CEmOC to the city of Maputo and the southern area of Maputo Province. In 2001, this hospital attended 32% of deliveries and 38% of cesarean sections in the city, up from 14 and 2.5%, respectively, in 1998. The Mavalane Hospital failed to provide CEmOC; however, the number of deliveries per year almost doubled. The Manhica hospital carried out 31% of the District's C-sections in 2001, up from 9% in 1998. In Sofala Province, one additional CEmOC and four BEmOCs were installed and case fatality rates decreased. In conclusion, the strategy for ensuring provision of EmOC is feasible even in countries with minimal resources and a scarcity of physicians, such as Mozambique. (C) 2004 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.