title: Assessment of obstetric and neonatal health services in developing country health facilities.
abstract: OBJECTIVE
  To describe the staffing and availability of medical equipment and medications and the performance of procedures at health facilities providing maternal and neonatal care at African, Asian, and Latin American sites participating in a multicenter trial to improve emergency obstetric/neonatal care in communities with high maternal and perinatal mortality.
  
  
  METHODS
  In 2009, prior to intervention, we surveyed 136 hospitals and 228 clinics in 7 sites in Africa, Asia, and Latin America regarding staffing, availability of equipment/medications, and procedures including cesarean section.
  
  
  RESULTS
  The coverage of physicians and nurses/midwives was poor in Africa and Latin America. In Africa, only 20% of hospitals had full-time physicians. Only 70% of hospitals in Africa and Asia had performed cesarean sections in the last 6 months. Oxygen was unavailable in 40% of African hospitals and 17% of Asian hospitals. Blood was unavailable in 80% of African and Asian hospitals.
  
  
  CONCLUSIONS
  Assuming that adequate facility services are necessary to improve pregnancy outcomes, it is not surprising that maternal and perinatal mortality rates in the areas surveyed are high. The data presented emphasize that to reduce mortality in these areas, resources that result in improved staffing and sufficient equipment, supplies, and medication, along with training, are required.
authors: Centre for Infectious Disease Zambia, Lusaka, Zambia.
authors: Albert
authors: A
authors: Manasyan
authors: Sarah
authors: S
authors: Saleem
authors: Marion
authors: M
authors: Koso-Thomas
authors: Fernando
authors: F
authors: Althabe
authors: Omrana
authors: O
authors: Pasha
authors: Elwyn
authors: E
authors: Chomba
authors: Shivaprasad S
authors: SS
authors: Goudar
authors: Archana
authors: A
authors: Patel
authors: Fabian
authors: F
authors: Esamai
authors: Ana
authors: A
authors: Garces
authors: Bhala
authors: B
authors: Kodkany
authors: Jose
authors: J
authors: Belizan
authors: Elizabeth M
authors: EM
authors: McClure
authors: Richard J
authors: RJ
authors: Derman
authors: Patricia
authors: P
authors: Hibberd
authors: Edward A
authors: EA
authors: Liechty
authors: K Michael
authors: KM
authors: Hambidge
authors: Waldemar A
authors: WA
authors: Carlo
authors: Pierre
authors: P
authors: Buekens
authors: Janet
authors: J
authors: Moore
authors: Linda L
authors: LL
authors: Wright
authors: Robert L
authors: RL
authors: Goldenberg
mesh_terms: D001118:Argentina; D001771:Blood Banks / Q000600:supply & distribution; D040421:Cell Phone / Q000600:supply & distribution; D003906:Developing Countries; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D004865:Equipment and Supplies, Hospital / Q000600:supply & distribution; D005260:Female; D006166:Guatemala; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007194:India; D020407:Internet; D007630:Kenya; D008427:Maternal Health Services / Q000706:statistics & numerical data; D009721:Nurse Midwives / Q000600:supply & distribution; D009774:Obstetrics / Q000706:statistics & numerical data; D010100:Oxygen / Q000600:supply & distribution; D010154:Pakistan; D010820:Physicians / Q000600:supply & distribution; D011247:Pregnancy; D000078329:Workforce; D015024:Zambia
chemical_list: D010100:Oxygen