Situation analysis of obstetric care services in a rural district in Zimbabwe.
OBJECTIVE
To conduct a situation analysis of obstetric services in a rural district of Zimbabwe.


METHODS
Observational study.


METHODS
13 primary health care centres in Murewa district in Zimbabwe.


METHODS
Number of maternity beds, antenatal attendance, deliveries per month, availability of antenatal, intrapartum and neonatal care equipment, intrapartum monitoring and neonatal resuscitation skills.


RESULTS
13 of 15 primary health care clinics providing obstetric care in Murewa district were surveyed in 1995. Median number of maternity beds were nine (Q1 = 0, Q3 = 11) per clinic, median number of first ANC attenders per month was 15 (Q1 = 3, Q3 = 18), median number of deliveries per clinic per month were eight (Q1 = 0, Q3 = 16). While all clinics had laboratory facilities, 6/13 could estimate haemoglobin, 5/13 syphilis serology, none of the clinics sent blood to district hospitals for blood grouping and there were no microscopes at clinics for malaria parasite determination. Only 6/13 clinics used partographs for monitoring labour, 10/13 had suction machines for neonatal resuscitation while only 3/13 had ambu bags, 3/13 had oxygen and 2/13 had heaters. Correct methods for neonatal resuscitation were used in 3/13 clinics. Clean water supply, reliable power supply and the referral system were not optimal.


CONCLUSIONS
Basic equipment for antenatal, intrapartum and neonatal care was inadequate. Essential laboratory facilities for obstetric care were lacking. Skills for intrapartum monitoring and neonatal resuscitation were inadequate. The referral system was poor. There is need for more strategic planning at primary health care level in this district which is known to have high perinatal and neonatal death rates. More emphasis should be placed on strengthening basic laboratory back up service for obstetric care, strengthening infrastructural and referral systems as well as training in areas of lost or no skills.
Department of Paediatrics and Child Health, Medical School, University of Zimbabwe, P O Box A 178, Avondale, Harare, Zimbabwe. rkambarami@healthnet.zw
R A
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Kambarami
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Chirenje
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Rusakaniko
D000328:Adult; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008991:Monitoring, Physiologic / Q000379:methods; D009774:Obstetrics / Q000295:instrumentation / Q000592:standards*; D018743:Perinatal Care / Q000379:methods*; D011320:Primary Health Care / Q000458:organization & administration / Q000592:standards*; D019035:Rural Health Services / Q000458:organization & administration / Q000592:standards*; D015030:Zimbabwe