EOC Newsletter June 2011

Sources of DataData from 690 health facilities consisting 14 Medical CollegeHospitals, 62 District and General Hospitals, 416 Upazila HealthComplexes, 63 Maternal and Child Welfare Centers (MCWCs),and NGOs and Private hospitals from 64 districts, and 7 Othertypes of hospitals have been used for analysis. An estimate ofthe current population, expected births and expectedcomplications of pregnancies has been used. These data havebeen drawn through adjustment of population census data of2001 carried out by Bangladesh Bureau of Statistics (BBS)considering a linear population growth rate of 1.41% per year.The projected populations of year 2010 by division,Table-1. Number of different types of health facilitiesfrom where EmOC Service data werw received in2010Type of hospitalsNo.Medical college hospitals 14District and general hospitals 62Upazila health complexes 416Districts from where NGO providers sent data 64Districts from where private providers sent data 64Maternal and Child Welfare Centers (MCWCs) 63Other Sources 7Total 690district and upazila have been worked out and used togenerate the expected number of births for each area.Finally the expected number of births has been used tocalculate the process indicators.ResultTable-2. Division-wise distribution of EmOC serviceand status in number (Year 2010)Name ofDivisionTotal CesareanDelivery SectionLiveBirthStillBirthMaternalDeathNeonatalDeathBarisal 27,803 14,252 26,980 1,071 143 505Chittagong 82,880 29,740 80,277 3,505 257 501Dhaka 184,234 95,975 180,823 4,887 537 399Khulna 73,605 31,462 72,571 1,641 119 147Rajshahi 86,415 24,168 85,128 2,159 212 165Rangpur 70,397 23,460 69,001 2,393 255 257Sylhet 33,378 11,612 31,453 2,206 177 306Bangladesh 558,712 230,669 546,223 17,862 1,700 2,280Table-2 shows the division-wise distribution of totaldeliveries, caesarean sections, live births, still births,maternal deaths and newborn deaths in the healthfacilities. Data show that there were 558,712 reporteddeliveries at EmOC facilities in the country in 2010 and outof them 546,223 were live births and 17,862 were stillbirths. Among the total deliveries, cesarean sections were230,669. There were 1,700 maternal deaths (reporteddeaths in the health facilities) and 2,280 newborn deaths(only the reported deaths in the facilities).Table-3. Number of populations, expected births and obstetric complications estimated for year 2010 bydivision of BangladeshCategory Barisal Chittagong Dhaka Khulna Rajshahi Rangpur Sylhet TotalPopulation (2001) 8,560,027 25,320,819 40,928,700 15,332,224 17,121,146 14,466,013 8,289,977 130,018,906Population (2010) 9,709,486 28,720,953 46,424,695 17,391,068 19,420,211 16,408,541 9,403,173 147,478,127Expected Births (2010) 199,433 589,928 953,563 357,213 398,891 337,031 193,141 3,029,201Estimated Complications (2010) 29,915 88,489 143,034 53,582 59,834 50,555 28,971 454,380Table-4. Division-wise distribution of status of indicators translated from summary of EmOC data received fromhealth facilities (Year 2010)Category Barisal Chittagong Dhaka Khulna Rajshahi Rangpur Sylhet TotalVisit for ANC service (No.) 63,750 251,178 561,926 230,181 165,960 178,045 65,380 1,516,420Admitted patient (No.) 41,135 105,625 253,992 102,445 120,809 94,639 48,328 766,973Complication treated (No.) 15,610 35,470 98,873 28,612 28,628 18,228 18,409 243,830Normal delivery (No.) 13,445 51,275 86,301 41,465 61,510 45,541 20,689 320,226Forceps / Vacuum / Destructive operation (No.) 34 938 949 336 376 753 621 4,007Vaginal Breech / Face Presentation Delivery (No.) 72 927 1,009 342 361 643 456 3,810Other surgery (No.) 862 4,887 10,193 2,319 3,740 1,987 3,044 27,032Referred in (No.) 1,128 7,349 5,523 2,076 1,515 1,606 1,060 20,257Referred out (No.) 2,482 5,045 10,262 3,602 5,879 5,662 3,395 36,327Visit for PNC services (No.) 18,848 88,611 255,917 65,387 70,881 66,582 30,920 597,146Proportion (%) of all births in EmOC facilities 13.94 14.05 19.32 20.61 21.66 20.89 17.28 18.44Met need (%) for EmOC 52.18 40.08 69.13 53.40 47.85 36.06 63.54 53.66Cesarean section as % of all births 7.15 5.04 10.06 8.81 6.06 6.96 6.01 7.61Case Fatality Rate (CFR) (%) 0.92 0.72 0.54 0.42 0.74 1.40 0.96 0.7003