Soins maternels intensifs (Maternal Intensive Care) en Belgique - KCE

Biswas, A.B. et
al (2005)
108 Maternal Intensive Care in Belgium KCE Reports 94
10 India (West
Bengal)
408 health
facilities
major obstetric haemorrhage was
made. Data about demographics,
facilities, staffing, policies and
guidelines, drugs, procedures,
equipment, point of care testing,
availability of O neg blood were
obtained.
A health facility based case finding
cross sectional study on process
indicators and min. level of EmOC
in all government health facilities
and registered private health
institutions providing maternity
services in 4 districts of West
Bengal. Relevant records and
registers for 2001 of all studied
facilities in the districts were
reviewed to collect data using a
pre-designed assessment schedule
designed by UNICEF. Interviews
with key health officials and staff
members were conducted (jan-dec
2001) if clarification of any
recorded data was required..
Measured process indicators:
number of basic EmOC facilities,
number of comprehensive EmOC
facilities, geographical distribution
of EmOC facilities, proportion of
Cross sectional
health facility
survey of minimum
levels of EmOC
not have a supply of blood for emergencies.
Half of all units (n=121) had on-site intensive
care or high dependency facilities and 72.9%
(n=175) had an on-site cardiac arrest team.
Only 58.8% of units (n=141) had a written
haemorrhage protocol. CONCLUSION:
Haemorrhage responds well to appropriate
treatment, although careful preparation and
anticipation of problems is required. In our
region geographical factors and different
systems of healthcare complicate provision of
obstetric services. Observation of blood loss
> 1000ml should ideally be in an HDU.
Where facilities are limited, women should
be offered antenatal transfer to a larger
centre.
OBJECTIVE: This study aims to asses the
availability and use of emergency obstetric
care (EmOC) services based on 7 process
indicators prescribed by
WHO/UNICEF/UNFPA. These indicators
have been recommended to monitor the
availability and use of EmOC services.
RESULTS: The numbers of basic and
comprehensive EmOC facilities were
inadequate in all the four districts compared
to the minimum acceptable level. Overall,
26.2% of estimated annual births took place
in the EmOC facilities (ranged from 16.2% to
45.8% in 4 districts) against the required
minimum of 15%. The rate of caesarean
section calculated for all expected births in
the population varied from 3.5% to 4.4% in
the four districts with an overall rate of 4%,
which is less than the minimum target of 5%.
Only 29.9% of the estimated number of
complications (which is 15% of all births) was
managed in the EmOC facilities. The
1+
2+
3+
4?
5?
6+/-
7?
8+
9+
10?
Score:+/-
3