Availability, utilization and quality of emergency obstetric care services in Sousse, Tunisia

Pan Afr Med J. 2021 Mar 16:38:272. doi: 10.11604/pamj.2021.38.272.17758. eCollection 2021.

Abstract

Introduction: emergency obstetric care (EmOC) is a high-impact priority intervention strongly recommended for improving maternal health outcomes. The objectives of this study were to assess the availability, utilization, and quality of emergency obstetric care services in the Governorate of Sousse (Tunisia).

Methods: a cross-sectional study was conducted among public health facilities which performed deliveries in Sousse in 2017. Data were collected by consulting clinical records and registers and interviewing staff using WHO EmOC tools. Emergency obstetric care (EmOC) indicators were calculated.

Results: only the University maternity Unit functioned as full comprehensive EmOC facility. No other public facility provided all the 7 Basic EmOC signal functions 3 months prior to the survey. The unperformed signal functions were: administration of parenteral antibiotics, manual removal of placenta and assisted vaginal delivery. The number of EmOC facilities was 0.72 per 500,000 inhabitants. The met need for EmOC was 89.5%. The proportion of caesarean section was 24.2%. The direct obstetric case fatality rate was 0.159% and intrapartum and very early neonatal death rate was 0.65%.

Conclusion: raising maternity facilities to a minimum level of basic EmOC status would be a major contributing step towards maternal mortality reduction.

Keywords: Emergency obstetric care; Sousse; Tunisia; maternal health.

MeSH terms

  • Cesarean Section / statistics & numerical data
  • Cross-Sectional Studies
  • Delivery, Obstetric / statistics & numerical data
  • Emergency Medical Services / organization & administration*
  • Emergency Medical Services / standards
  • Female
  • Health Facilities / standards
  • Health Facilities / statistics & numerical data
  • Humans
  • Infant, Newborn
  • Maternal Health Services / organization & administration*
  • Maternal Health Services / standards
  • Maternal Mortality
  • Obstetrics / organization & administration*
  • Obstetrics / standards
  • Perinatal Death
  • Pregnancy
  • Quality of Health Care*
  • Tunisia