Availability and distribution of, and geographic access to emergency obstetric care in Zambia

Gabrysch, S; Simushi, V; Campbell, OMR; (2011) Availability and distribution of, and geographic access to emergency obstetric care in Zambia. International journal of gynaecology and obstetrics, 114 (2). pp. 174-179. ISSN 0020-7292 DOI: https://doi.org/10.1016/j.ijgo.2011.05.007

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Objective: To assess the availability and coverage of emergency obstetric care (EmOC) services in Zambia. Methods: Reported provision of EmOC signal functions in the Zambian Health Facility Census and additional criteria on staffing, opening hours, and referral capacity were used to classify all Zambian health facilities as providing comprehensive EmOC, basic EmOC, or more limited care. Geographic accessibility of EmOC services was estimated by linking health facility data with data from the Zambian population census. Results: Few Zambian health facilities provided all basic EmOC signal functions and had qualified health professionals available on a 24-hour basis. Of the 1131 Zambian delivery facilities, 135 (12%) were classified as providing EmOC. Zambia nearly met the UN EmOC density benchmarks nationally, but EmOC facilities and health professionals were unevenly distributed between provinces. Geographic access to EmOC services in rural areas was low; in most provinces, less than 25% of the population lived within 15 km of an EmOC facility. Conclusion: A national Health Facility Census with geographic information is a valuable tool for assessing service availability and coverage at national and subnational levels. Simultaneously assessing health worker density and geographic access adds crucial information. (C) 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Item Type: Article
Keywords: Data linkage, Emergency obstetric care, Health services accessibility, Maternal health services, Staffing levels, Zambia, process indicators, progress
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Centre for Maternal, Reproductive and Child Health (MARCH)
Maternal Health Group
PubMed ID: 21669427
Web of Science ID: 293316600026
URI: http://researchonline.lshtm.ac.uk/id/eprint/274


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