title: Setting an emergency obstetric care unit local initiatives, availability of resources and good will are the main ingredients of success: a lesson from Mkuranga District Hospital, Tanzania.
abstract: OBJECTIVE
  Mkuranga District Hospital is 50 km South of Dar-Es-Salaam city serving a population of about 196,000. Before June 2004, all obstetric patients with complications from this district were referred to Dar-Es-Salaam as the hospital had no comprehensive emergency obstetric care (CEmOC) skilled personnel. In June 2004, a project was started using local manpower and resources to impart knowledge for CEmOC. The aim was to reduce referrals to Dares Salaam and hence delays in receiving CEmOC.
  
  
  METHODS
  Hospital staffs were trained on CEmOC which included the use of partography and management of common obstetric emergencies. The list of lacking essential equipments for CEmOC was made and submitted to the district management for purchases. Weekly visit by the project manager was arranged for monitoring of the project.
  
  
  RESULTS
  There was a three to four fold increase in the monthly-number of deliveries in the hospital and referrals decreased sharply. Almost all major obstetric intervention were performed in the hospital and only 20% of patients were referred.
  
  
  CONCLUSIONS
  The findings from this project show that using local initiatives, resources and advocacy can give a good outcome of obstetric services.
authors.affiliation: Ministry of Health and Social Welfare, Dar es Salaam, Tanzania. amakuwani@yahoo.com
authors.forename: A M
authors.initials: AM
authors.lastname: Makuwani
authors.forename: S N
authors.initials: SN
authors.lastname: Massawe
authors.forename: R
authors.initials: R
authors.lastname: Mpembeni
authors.forename: A
authors.initials: A
authors.lastname: Shekimweri
mesh_terms: D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D006282:Health Personnel / Q000193:education*; D006295:Health Resources; D006297:Health Services Accessibility; D006767:Hospitals, District; D006801:Humans; D008427:Maternal Health Services / Q000458:organization & administration*; D009774:Obstetrics / Q000458:organization & administration*; D011247:Pregnancy; D011787:Quality of Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data; D013636:Tanzania