title: Disease burden due to pre-eclampsia/eclampsia and the Ethiopian health system's response.
abstract: OBJECTIVE
  To assess the maternal disease burden due to pre-eclampsia/eclampsia in Ethiopia and the national health system's readiness to respond to the needs of women with pre-eclampsia/eclampsia.
  
  
  METHODS
  The national emergency obstetric and newborn care (EmONC) assessment entailed collecting information from 112 hospitals and 685 health centers in Ethiopia, focusing on their infrastructure, the services they provided, human resources, equipment and supplies, case load, and mortality due to pre-eclampsia/eclampsia.
  
  
  RESULTS
  Pre-eclampsia/eclampsia complicated 1.2% of all institutional deliveries. Given the low institutional delivery rate and an expected incidence of 2%-8% of all deliveries, this implies that only a small fraction (3.8%) of all women with pre-eclampsia/eclampsia received care at health facilities. 11% of all maternal deaths and 16% of direct maternal deaths were due to this obstetric complication. The cause-specific case fatality rate was high (3.6%). Availability of urine test strips, anticonvulsants, antihypertensives, and actual service provision to treat these diseases was limited, especially at health centers.
  
  
  CONCLUSIONS
  The salutary effects of the national EmONC assessment were immediate, as evidenced by how quickly the release of the Ethiopian report led to important national efforts to improve maternal and newborn health. Expansion of health services should be augmented with periodic assessments of logistics and quality-related issues to assure functioning facilities for women accessing obstetric services.
authors.affiliation: United Nations Children's Fund, Addis Ababa, Ethiopia. agaym@unicef.org
authors.forename: Asheber
authors.initials: A
authors.lastname: Gaym
authors.forename: Patricia
authors.initials: P
authors.lastname: Bailey
authors.forename: Luwei
authors.initials: L
authors.lastname: Pearson
authors.forename: Keseteberhan
authors.initials: K
authors.lastname: Admasu
authors.forename: Yirgu
authors.initials: Y
authors.lastname: Gebrehiwot
mesh_terms: D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004461:Eclampsia / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D004632:Emergency Medical Services / Q000592:standards / Q000706:statistics & numerical data; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008428:Maternal Mortality; D011225:Pre-Eclampsia / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D011247:Pregnancy; D011787:Quality of Health Care