title: Availability and quality of emergency obstetric care, an alternative strategy to reduce maternal mortality: experience of Tongji Hospital, Wuhan, China.
abstract: The burden of maternal mortality (MM) and morbidity is especially high in Asia. However, China has made significant progress in reducing MM over the past two decades, and hence maternal death rate has declined considerably in last decade. To analyze availability and quality of emergency obstetric care (EmOC) received by women at Tongji Hospital, Wuhan, China, this study retrospectively analyzed various pregnancy-related complications at the hospital from 2000 to 2009. Two baseline periods of equal length were used for the comparison of variables. A total of 11 223 obstetric complications leading to MM were identified on a total of 15 730 hospitalizations, either 71.35% of all activities. No maternal death was recorded. Mean age of women was 29.31 years with a wide range of 14-52 years. About 96.26% of women had higher levels of schooling, university degrees and above and received the education of secondary school or college. About 3.74% received primary education at period two (P2) from 2005 to 2009, which was significantly higher than that of period one (P1) from 2000 to 2004 (P<0.05) (OR: 0.586; 95% CI: 0.442 to 0.776). About 65.69% were employed as skilled or professional workers at P2, which was significantly higher than that of P1 (P<0.05). About 34.31% were unskilled workers at P2, which was significantly higher than that of P1 (P<0.05). Caesarean section was performed for 9,930 women (88.48%) and the percentage of the procedure increased significantly from 19.25% at P1 to 69.23% at P2 (P<0.05). We were led to conclude that, despite the progress, significant gaps in the performance of maternal health services between rural and urban areas remain. However, MM reduction can be achieved in China. Priorities must include, but not limited to the following: secondary healthcare development, health policy and management, strengthening primary healthcare services.
authors.affiliation: Department of Health Management School of Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Ismael Fatou
authors.initials: IF
authors.lastname: Bangoura
authors.affiliation: Bayer Healthcare Company, Kaiser-Wilhelm-Allee, Bldg., E3951368, Leverkusen, Germany.
authors.forename: Jian
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Chronic Disease, Hubei Provincial Academy of Preventive Medicine, Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China.
authors.forename: Xun
authors.initials: X
authors.lastname: Gong
authors.affiliation: Management School of Hubei University of Chinese Medicine, Wuhan, 430065, China.
authors.forename: Xuanxuan
authors.initials: X
authors.lastname: Wang
authors.affiliation: School of Public Health, Xinjiang Medical University, Urumqi, 830011, China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Wei
authors.affiliation: Department of Health Management School of Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Wenbin
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Health Management School of Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. zhangchxiang@163.com.
authors.forename: Xiang
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Health Management School of Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Pengqian
authors.initials: P
authors.lastname: Fang
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China; D004632:Emergency Medical Services / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008428:Maternal Mortality; D008875:Middle Aged; D007744:Obstetric Labor Complications / Q000401:mortality* / Q000517:prevention & control*; D009774:Obstetrics / Q000592:standards / Q000706:statistics & numerical data*; D011247:Pregnancy; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data; D018570:Risk Assessment; D055815:Young Adult