Availability and quality of emergency obstetric care in Gambia's main referral hospital: women-users' testimonies.
Availability and quality of emergency obstetric care in Gambia's main referral hospital: women-users' testimonies.
复制标题
DOI：
10.1186/1742-4755-6-5
复制
发表时间：
2009-04-14
影响因子：
3.4
通讯作者：
Vangen, Siri
中科院分区：
文献类型：
--
作者：
Cham, Mamady;Sundby, Johanne;Vangen, Siri
背景：到2015年将产妇死亡率降低三分之二是一项国际发展目标，为实现这一目标，应促进不受限制地获得高质量的产科急救服务。这项定性研究的目的是评估冈比亚主要转诊医院的产科急救服务的可用性和质量。方法：从周末入院开始，有目的地选择30名因不同产科急症接受治疗的妇女，包括出血、高血压疾病、难产、败血症和贫血5个主要诊断组。在她们出院后的两周内，在她们的家中进行了深入的访谈。结果：在获得产科急救方面发现了很大的困难。卫生系统的缺陷，包括缺乏用于输血的血液，基本药物，特别是抗高血压药物的短缺，大大阻碍了产科紧急情况的及时和适当治疗。这样的不足也将治疗成本推高至标准费用的5至18倍。输血和高血压治疗的费用最高。结论：救命干预措施的缺乏是孕产妇保健服务经费不足的表现。因此，有必要大幅增加产妇保健服务的资金，以便在冈比亚有效实施紧急产科护理一揽子计划。
BACKGROUND: Reduction of maternal mortality ratio by two-thirds by 2015 is an international development goal with unrestricted access to high quality emergency obstetric care services promoted towards the attainment of that goal. The objective of this qualitative study was to assess the availability and quality of emergency obstetric care services in Gambia's main referral hospital.METHODS: From weekend admissions a group of 30 women treated for different acute obstetric conditions including five main diagnostic groups: hemorrhage, hypertensive disorders, dystocia, sepsis and anemia were purposively selected. In-depth interviews with the women were carried out at their homes within two weeks of discharge.RESULTS: Substantial difficulties in obtaining emergency obstetric care were uncovered. Health system inadequacies including lack of blood for transfusion, shortage of essential medicines especially antihypertensive drugs considerably hindered timely and adequate treatment for obstetric emergencies. Such inadequacies also inflated the treatment costs to between 5 and 18 times more than standard fees. Blood transfusion and hypertensive treatment were associated with the largest costs.CONCLUSION: The deficiencies in the availability of life-saving interventions identified are manifestations of inadequate funding for maternal health services. Substantial increase in funding for maternal health services is therefore warranted towards effective implementation of emergency obstetric care package in The Gambia.