Doctors with Africa Cuamm Mothers and Children First: the first steps - Ethiopia Info: www.doctorswhithafrica.org
Wolisso, Goro and Wonchi Districts
per 1,000 live births (81,726 deaths per year). • Stillbirth is 25.6 per 1,000 live births (equal to 82,360 deaths per year).
Mekele Gonder
Wolisso Addis Abeba Werder
Geto Dubbo
Dolo Odo Moyalè
National health statistics • 38.9% of the population lives under poverty threshold of 1.25 USD per day. • Maternal Mortality rate is 676 per 100,000 lives births (25,000 maternal deaths per year). • The under five mortality rate is 46 per 1,000 live births (194,000 deaths per year). • Neonatal mortality rate is 31
National health policies and data • The ratio of health personnel is 2.4 every 10,000 inhabitants. • Per capita health expenditure is 42 USD (in PPP). • The national health plan includes a safe motherhood programme. • The decentralization programme of the health sector includes the strengthening of the maternal care on the territory. • A programme at national level is being implemented that shortens the training period and allows for a bigger number of midwives to be trained.
Cuamm: n. 1 surgeon, n. 1 paediatrician, n. 1 public health specialist. • Services provided at district level: free transport and management of emergency obstetric, drug supply, capacity building of local human resources.
Intervention in Wolisso, goro and Wonchu District • Total population of 372,478 inhabitants (14,170 expected deliveries). • Health facilities: n. 6 peripheral maternal units and Wolisso Hospital of the Ethiopian Episcopal Conference (200 beds). • Number of midwives: 29. • Expatriate personnel of Doctors with Africa
Tool: World Bank 2005 Ethiopia Demographic Health Survey 2011 World Health Statistics 2012
Activities in 2012 (first year of implementation) N. of skilled attended deliveries (over the expected deliveries in the district)
2,830 (20%)
N. of skilled attended deliveries in Wolisso Hospital
1,875
N. of caesarean sections
351
Ratio of caesarean sections to number of births expected (5-15% standard)
2.5%
N. of transports for obstetric emergencies
73
N. of health personnel trained in obstetric and neonatal emergencies
21
Direct obstetric maternal fatality rate at hospital level (standard <1)
0.38%
Proportion of hospital maternal deaths due to indirect causes
Figure 1. Essential obstetric and neonatal emergency care 1 Available service Unavailable service
1 Parenteral administration of antibiotics
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Services 1 - 7 Basic essential obstetric and neonatal care / BEmOC Basic Emergency
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Services 1 - 9 Comprehensive essential obstetric and neonatal care / CEmOC
Wolisso Hospital Health Centre 1 Health Centre 2 2 Parenteral administration of oxytocin
Health Centre 3 Health Centre 4 Health Centre 5 Health Centre 6
Wolisso, Goro, Wonchi District Ethiopia
9 Cesarean section
3 Removal of retained products of conception
4 Manual removal of placenta
8 Blood transfusion
7 Assisted vaginal delivery with vacuum or forceps
5 Newborn resuscitation with mask and ambubag 6 Parenteral administration of anticonvulsants
1
Tool used: Need assessment of emergency and neonatal care, Columbia University, AMDD 2011.
20%