Availability and utilization of obstetric and newborn care in Guinea: A national needs assessment.
OBJECTIVE
To assess the availability and utilization of emergency obstetric and neonatal care (EmONC) in Guinea given the high maternal and neonatal mortality rates.


METHODS
We used the Guinea 2012 needs assessment data collected via a national cross-sectional census of health facilities conducted from September to October 2012. All public, private, and faith-based health facilities that performed at least one delivery during the period of the study were included.


RESULTS
A total of 502 health facilities were visited, of which 81 were hospitals. Only 15 facilities were classified as fully functioning EmONC facilities, all of which were reference hospitals. None of the first level health facilities were fully functioning EmONC facilities. The ratio of availability of EmONC was one fully functioning EmONC facility for 745 415 inhabitants. The institutional delivery rate was 32.3% and the proportion of all births in EmONC facilities was 7.1%. Met need for EmONC was 12.2%. Among 201 maternal deaths in EmONC facilities, 69 were due to indirect causes. The intrapartum and very early neonatal death rate was 39 deaths per 1000 live births.


CONCLUSIONS
The study showed low availability of EmONC services and underutilization of the available services. Further investigation is needed to evaluate the effect of the current policy of user fees exemption for deliveries and prenatal care in Guinea.
Research Institute of Health Sciences, Ouagadougou, Burkina Faso; Kaya Health and Demographic Surveillance System, Kaya, Burkina Faso. Electronic address: abaguiya@gmail.com.
Adama
A
Baguiya
Research Institute of Health Sciences, Ouagadougou, Burkina Faso; African Institute of Public Health, Ouagadougou, Burkina Faso.
Ivlabèhiré Bertrand
IB
Meda
Research Institute of Health Sciences, Ouagadougou, Burkina Faso; African Institute of Public Health, Ouagadougou, Burkina Faso.
Tieba
T
Millogo
Directorate of Family Health and Nutrition, Ministry of Health and Public Hygiene of Guinea, Conakry, Guinea.
Mamadou
M
Kourouma
Averting Maternal Death and Disability, Mailman School of Public Health, Columbia University, New York, USA.
Halima
H
Mouniri
Research Institute of Health Sciences, Ouagadougou, Burkina Faso; Kaya Health and Demographic Surveillance System, Kaya, Burkina Faso; African Institute of Public Health, Ouagadougou, Burkina Faso.
Seni
S
Kouanda
D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D016701:Guinea; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007229:Infant Welfare / Q000706:statistics & numerical data; D007231:Infant, Newborn; D008429:Maternal Welfare / Q000706:statistics & numerical data; D000068101:Maternal-Child Health Services / Q000706:statistics & numerical data*; D020380:Needs Assessment; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology
EmONC; Emergency obstetric and newborn care; Guinea; Maternal health; Neonatal health