title: Availability, utilization, and quality of emergency obstetric care services in Bauchi State, Nigeria.
abstract: OBJECTIVE
  To report the availability, utilization, and quality of emergency obstetric care (EmOC) services in Bauchi State, Nigeria.
  
  
  METHODS
  Between June and July 2012, a cross-sectional survey of health facilities was conducted. Data on the performance of EmOC services between June 2011 and May 2012 were obtained from records of 20 general hospitals and 39 primary healthcare centers providing delivery services. Additionally, structured interviews with facility managers were conducted.
  
  
  RESULTS
  Only 6 (10.2%) of the 59 facilities met the UN requirements for EmOC centers. None of the three senatorial zones in Bauchi State had the minimum acceptable number of five EmOC facilities per 500 000 population. Overall, 10 517 (4.4%) of the estimated 239 930 annual births took place in EmOC facilities. Cesarean delivery accounted for 3.6% (n=380) of the 10 517 births occurring in EmOC facilities and 0.2% of the 239 930 expected live births. Only 1416 (3.9%) of the expected 35 990 obstetric complications were managed in EmOC facilities. Overall, 45 (3.2%) of 1416 women with major direct obstetric complications treated at EmOC facilities died. Among 379 maternal deaths, 317 (83.6%) were attributable to major direct obstetric complications.
  
  
  CONCLUSIONS
  Availability, utilization, and quality of EmOC services in Bauchi State, Nigeria, are suboptimal. The health system's capacity to manage emergency obstetric complications needs to be strengthened.
authors.affiliation: Health and Economics Consultants, Ilorin, Nigeria.
authors.forename: Dele
authors.initials: D
authors.lastname: Abegunde
authors.affiliation: Jhpiego Targeted States High Impact Project, Bauchi, Nigeria. Electronic address: ikabo@tshipnigeria.org.
authors.forename: Ibrahim A
authors.initials: IA
authors.lastname: Kabo
authors.affiliation: John Snow Incorporated Research and Training Institute Targeted States High Impact Project, Bauchi, Nigeria.
authors.forename: William
authors.initials: W
authors.lastname: Sambisa
authors.affiliation: John Snow Incorporated Research and Training Institute Targeted States High Impact Project, Bauchi, Nigeria.
authors.forename: Toyin
authors.initials: T
authors.lastname: Akomolafe
authors.affiliation: John Snow Incorporated Research and Training Institute Targeted States High Impact Project, Bauchi, Nigeria.
authors.forename: Nosa
authors.initials: N
authors.lastname: Orobaton
authors.affiliation: John Snow Incorporated Research and Training Institute Targeted States High Impact Project, Bauchi, Nigeria.
authors.forename: Masduk
authors.initials: M
authors.lastname: Abdulkarim
authors.affiliation: Jhpiego Targeted States High Impact Project, Bauchi, Nigeria.
authors.forename: Habib
authors.initials: H
authors.lastname: Sadauki
mesh_terms: D002585:Cesarean Section / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D004630:Emergencies / Q000453:epidemiology*; D004632:Emergency Medical Services / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008428:Maternal Mortality; D009549:Nigeria / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome
keywords: Availability; Emergency obstetric services; Maternal mortality; Nigeria; Northern Nigeria; Quality; Utilization