The 130th Annual Meeting of APHA

4289.0: Tuesday, November 12, 2002 - Board 1

Abstract #49149

Addressing barriers of access to emergency obstetric care among war-affected populations

Henia Dakkak, MD, MPH, Women's Commission for Refugee Women and Children, Columbia University - School of Public Health - Heilbrunn Center for Population and Family Health, 122 East 42nd Street, 12 Floor, New York, NY 10168, 212-551-3113,

Learning Objectives: At end of session, participants will be able to: 1. List barriers and gaps in receiving EmOC faced by pregnant women at time of delivery among war-affected populations. 2. Prioritize intervention strategies for project implementation and evaluation.

Background: Reproductive Health for Refugees Consortium conducted an assessment of EmOC in 11 sites among war-affected populations as part of three years project under “Averting Maternal Death and Disability” (AMDD) program through grant from Gates foundation to Columbia University

Setting: Project Sites for EmOC are: Bosnia, Sierra Leone, Liberia, Tanzania, South Sudan, Uganda, Kenya, Thailand and Pakistan

Partners: ARC, IRC, MSI, WCRWC and Columbia University – Center for Population and Family Health.

Results Pregnant women with obstetric complications among war-affected populations face an additional burden in accessing EmOC due to lack of: 1. Coordination and cooperation among service providers is an obstacle in war settings. 2. Support to transportation issues between health providers and donors regarding EmOC 3. Documentation of pregnancy outcomes for mothers and babies after delivery 4. Security, which affect decision to seek help 5. Trained health providers due to population movement 6. Infrastructure due physical damage to facilities 7. Equipment, supplies and medication and blood banks 8. Appropriate postpartum care, FP counseling and post-abortion care 9. Monitoring and training for health providers on regular basis


The project showed a big unmet need to improve coordination and cooperation among different agencies providing EmOC to war affected populations and aims to document findings and address the gaps through intervention, monitoring and evaluation.

Learning Objectives:

  • Background