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Peer-Reviewed Article | Availability of comprehensive emergency obstetric and neonatal care

In developing regions in Ethiopia: lessons learned from the USAID transform health activity

This study investigated the availability of Comprehensive Emergency Obstetric and Neonatal Care (CEmONC) Services signal functions and described lessons learned from the USAID Transform Health in Developing Regions Activity. A baseline cross-sectional study of 15 public hospitals in four developing regions of Ethiopia (Somali, Afar, Benishangul Gumz, and Gambella) was conducted and clinical mentorship was introduced in 10 selected hospitals. At baseline, 6 out of the 15 hospitals performed all 9 CEmONC signal functions, and one-third of the signal functions were performed in all hospitals. Cesarean Section service was available in 11 hospitals and blood transfusion was available in 10 hospitals. The least performed signal functions were blood transfusion, Cesarean Section, manual removal of placenta, removal of retained product of conceptus, and parenteral anticonvulsants. After implementing the clinical mentorship program, all CEmONC signal functions were available in all hospitals selected for the mentorship program except for Abala Hospital; the number of Cesarean Sections increased by 7.25%; and the number of women referred for blood transfusions and further management of obstetric complications decreased by 96.67%. However, post-cesarean Section surgical site infections, obstetric complications, facility maternal deaths, neonatal deaths, and stillbirths did not change. This indicates the need for investigating underlying and proximal factors that contributed to maternal death and stillbirth in the Developing Regional State of Ethiopia. There is also a need to assess the quality of the CEmONC services in the supported hospitals, institutionalize reviews, surveillance, and response mechanism for maternal, perinatal, and neonatal deaths and near misses.

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