Assessment of the capacity of Health facilities in the provision of basic emergency obstetric care services in Busia District.

Abstract

Background to the study: World wide, women face many risks at the time of giving birth and 15% of these suffer from such complication that become life threatening especially if not handled or managed appropriately and urgently by skilled health workers. The Government of Uganda and other health partners introduced the national guidelines for the delivery of basic obstetric care services and equipped health centers in Busia with medical supplies and equipment for the provision of obstetric care services among women of reproductive age 15-45 years and therefore, proper and better Basic Emergency Obstetric Care Services Provision can save many lives for mother and infants in Uganda. General and specific objectives: This study was set to assess the capacity of health facilities in the provision of basic emergency obstetric care services in Busia District. By examining the knowledge of basic emergency obstetric care services package among health workers working in the maternity section, determine availability of drugs for the provision of basic emergency obstetric care services, determine the availability of equipment and supplies for BEMOC and establish the staff cadre present to offer BEMOC in Busia District. Methodology: A cross-sectional research design was adopted with qualitative and quantitative data was used, with a sample of 90 respondents (Nurses and Midwives) and 8 Key informants (Health Facility in-Charge) selected using simple random sampling and purposive sampling techniques respectively. The quantitative data was collected using a questionnaire, and qualitative, using an interview-guide and a commodity check-list. Data analysis was done using the Statistical Package for Social Scientists (SPSS) version 18.0 to obtain descriptive and cross tabulation results at univariate and bivariate levels. Thematic content analysis for qualitative data respectively.

Results: Health workers in maternity unit had low capacity in terms of knowledge of basic emergency obstetric care services package 25(78.0%) had not performed manual vacuum aspiration (MVA) and could not perform the seven elements of BEMOC, the availability of drugs for the provision of basic emergency obstetric care services was insufficient in most health facilities, the availability of equipment and supplies for BEMOC was also low and the staff cadre present to offer BEMOC were few which required more recruitment of staff including doctors, nurses and midwives to cover the increasing number of patients in need of BEMOC in the district. Conclusion: Health workers in Busia District health facilities-maternity section had low/ inadequate knowledge about basic emergency obstetric care services package, the availability of drugs for the provision of basic emergency obstetric care services was inadequate, availability of equipment and supplies for BEMOC also was low/inadequate reflected by absence of essential equipment to offer basic emergency obstetric care services to mothers in the health facilities and staff cadre present to offer BEMOC in Busia District health facilities were few, nurses and midwives lacked support from doctors whom they considered more qualified to handle cases of manual removal of the placenta as they occurred. Recommendation: It was recommended that management of health facilities in Busia district should empower nurses and midwives and other health professionals with knowledge of making decisions especially with the provision of basic emergency obstetric care services.