Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #117127

Ellen Brazier, MA, Anglophone Africa Program, Family Care International, 508 Broadway, Suite 503, New York, NY 10025, (212) 941-5300, ebrazier@familycareintl.org, Ellen M. Themmen, MPH, Africa Program, Family Care International, 588 Broadway, Suite 503, New York City, NY 10012, and Elizabeth L. Westley, MPH, Family Care International, 588 Broadway, Suite 503, New York, NY 10012.

Evidence has shown that the single most effective way to prevent maternal deaths is to ensure that women give birth with a skilled health professional. Yet without substantial inputs, many facilities in poor and/or rural communities in Africa are not able to offer skilled care in line with WHO standards.

In preparation for a project to improve skilled care, we surveyed all facilities where women give birth in selected districts in Burkina Faso, Kenya, and Tanzania (N = 95). We used WHO's Safe Motherhood Needs Assessment methodology, which includes interviews with a range of staff and clients as well as observation-based assessments of supplies, equipment and infrastructure, adapted to reflect local conditions and the latest findings in maternal health. Analysis of data by signal function necessary to provide basic and comprehensive essential obstetric care reveals severe constraints in human and material resources, hampering the ability of facility staff to respond appropriately to both normal and complicated deliveries. Sites are understaffed and existing staff generally have weak skills; fewer than half have ever received refresher training and almost none knew how to use the partograph. In all three countries very few health center level sites were performing all six signal functions; often because of shortages of essential equipment and supplies. In Burkina Faso, only 15% of health centers had the minimum equipment needed to conduct deliveries. Without substantial improvements in services, women in these rural communities will not be able to benefit fully from delivering in institutions.

Learning Objectives: