Strengthening emergency obstetric care in Thanh Hoa and Quang Tri provinces in Vietnam.
OBJECTIVE
Save the Children/USA and the Ministry of Health of Vietnam undertook a project between 2001 and 2004 to improve the availability of, access to, quality and utilization of emergency obstetric care (EmOC) services at district and provincial hospitals in two provinces in Vietnam.


METHODS
The project improved the functional capacity of 3 provincial and 1 district hospitals providing comprehensive EmOC services, and upgraded 1 district hospital providing basic EmOC into a comprehensive EmOC facility through training, infrastructure and quality improvement.


RESULTS
Data presented in this paper focus on only the 2 district hospitals even though the UN process indicators showed increases in utilization of EmOC in all 5 hospitals. In the case of Hai Lang, the proportion of births increased from 13% at baseline to 31% at the end of 2004, and met need increased significantly from 16% to 87% largely due to increased capacity of the hospital and staff. Met need in Hoang Hoa hospital more than doubled (17% at baseline versus 54% in 2004) and the proportion of births increased slightly from 19% in 2001 to 22% in 2004. Case fatality rates for the two hospitals remarkably remained at zero. Lessons from this project have been incorporated into national policy and guidelines.


CONCLUSIONS
Improvements in the capacity of existing health facilities to treat complications in pregnancy and childbirth can be realized in a relatively short period of time and is an essential element in reducing maternal mortality.
Otchere
S A
SA
Save the Children/US, Washington DC, USA. Sotchere@savechildren.org
Binh
H T
HT
D036861:Delivery, Obstetric / Q000592:standards; D004636:Emergency Service, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility; D006767:Hospitals, District / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D008427:Maternal Health Services / Q000592:standards*; D008429:Maternal Welfare; D009775:Obstetrics and Gynecology Department, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D010043:Outcome and Process Assessment, Health Care; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards* / Q000706:statistics & numerical data; D016730:Program Development; D011785:Quality Assurance, Health Care; D014480:United Nations; D014744:Vietnam