Nasratullah Ansari1, Hannah Tappis2, Partamin Manalai3, Zelaikha Anwari4, Young Mi Kim2, Jos J M van Roosmalen1, Jelle Stekelenburg5,6. 1. Athena Institute, Faculty of Science, Vrije Universiteit, Amsterdam, The Netherlands. 2. Jhpiego, Baltimore, MD, USA. 3. Jhpiego Afghanistan, Kabul, Afghanistan. 4. Reproductive, Maternal, Newborn, Child and Adolescent Health Department, Ministry of Public Health, Kabul, Afghanistan. 5. Department of Health Sciences, Global Health, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. 6. Department of Obstetrics and Gynecology, Leeuwarden Medical Centre, Leeuwarden, The Netherlands.
Abstract
OBJECTIVE: To assess changes in readiness to provide emergency obstetric and newborn care (EmONC) in health facilities in Afghanistan between 2010 and 2016. METHODS: A secondary analysis was performed of a subset of data from cross-sectional health facility assessments conducted in December 2009 to February 2010 and May 2016 to January 2017. Interviews with health providers, facility inventory, and record review were conducted in both assessments. Descriptive statistics and χ2 tests were used to compare readiness of EmONC at 59 public health facilities expected to provide comprehensive EmONC. RESULTS: The proportion of facilities reporting provision of uterotonic drugs, anticonvulsants, parenteral antibiotics, newborn resuscitation, and cesarean delivery did not change significantly between 2010 and 2016. Provision of assisted vaginal deliveries increased from 78% in 2010 to 98% in 2016 (P<0.001). Fewer health facilities had amoxicillin (61% in 2016 vs 90% in 2010; P<0.001) and gentamicin (74% in 2016 vs 95% in 2010; P<0.002). The number of facilities with at least one midwife on duty 24 hours a day/7 days a week significantly declined (88% in 2016 vs 98% in 2010; P=0.028). CONCLUSION: Despite a few positive changes, readiness of EmONC services in Afghanistan in 2016 had declined from 2010 levels.
OBJECTIVE: To assess changes in readiness to provide emergency obstetric and newborn care (EmONC) in health facilities in Afghanistan between 2010 and 2016. METHODS: A secondary analysis was performed of a subset of data from cross-sectional health facility assessments conducted in December 2009 to February 2010 and May 2016 to January 2017. Interviews with health providers, facility inventory, and record review were conducted in both assessments. Descriptive statistics and χ2 tests were used to compare readiness of EmONC at 59 public health facilities expected to provide comprehensive EmONC. RESULTS: The proportion of facilities reporting provision of uterotonic drugs, anticonvulsants, parenteral antibiotics, newborn resuscitation, and cesarean delivery did not change significantly between 2010 and 2016. Provision of assisted vaginal deliveries increased from 78% in 2010 to 98% in 2016 (P<0.001). Fewer health facilities had amoxicillin (61% in 2016 vs 90% in 2010; P<0.001) and gentamicin (74% in 2016 vs 95% in 2010; P<0.002). The number of facilities with at least one midwife on duty 24 hours a day/7 days a week significantly declined (88% in 2016 vs 98% in 2010; P=0.028). CONCLUSION: Despite a few positive changes, readiness of EmONC services in Afghanistan in 2016 had declined from 2010 levels.
Authors: Christine Kim; Hannah Tappis; Laila Natiq; Bruce Fried; Kristen Hassmiller Lich; Paul L Delamater; Morris Weinberger; Justin G Trogdon Journal: Glob Public Health Date: 2021-01-18
Authors: Sandra Alba; Egbert Sondorp; Elisabeth Kleipool; Rajpal Singh Yadav; Arab S Rahim; Konrad T Juszkiewicz; Gilbert Burnham Journal: BMJ Glob Health Date: 2020-05