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Assessment of Unmet Need in Emergency Obstetric Services in Tarcha General Hospital, Dawro Zone, South West Ethiopia

Geremew Muleta Akessa

Introduction: Unmet obstetric need is an estimate of the number of women needing a major obstetric intervention for life-threatening complications who did not have access to appropriate care. There is limited evidence about unmet need for emergency obstetric care facilities in rural Ethiopia. This study identifies Major Obstetric Intervention for Absolute Maternal Indication.

Methods: A two years facility based Cross-sectional retrospective study was conducted from April 2012 to April 2014 at Tarcha General Hospital south-west Ethiopia. Data were collected using structured questioners by trained data collectors from Patient medical records. The collected data was analyzed using SPSS version 16.0. Descriptive statistics and inferential statistics was used to analyze the data.

Result: During the study period, 302 major obstetric interventions were conducted and caesarean sections took the largest 245(81.5%). Laparotomies and hysterectomies were done for mothers coming from rural than urban areas which was significant at 5%. Out of 238 women with AMI majority were cephalo-pelvic disproportion (CPD) which account 91(38.2%). The number of MOI done without AMI was 74 where majority were done for fetal distress 42(65.6%). The expected number of major obstetric interventions for absolute maternal indications per expected number of births is 0.8%. The high proportion 64 (21.2%) of negative maternal outcomes in terms of morbidity 22.2% and mortality 2.65%, as well as the high perinatal mortality of 25.8%.

Conclusion: Based on the 2% threshold, with an overall level of major obstetric interventions for absolute maternal indications of 0.8% and a caesarean section rate of 0.6% and high proportion of negative maternal and perinatal outcomes has significant unmet obstetric need with a considerable rural-urban disparity.