Background:
The goal of reducing maternal mortality can be achieved when women receive important service
components at the time of their maternity care. This study attempted to assess the availability and the components
of maternity services according to the perspectives of service users and providers.
Method:
A linked facility and population-based survey was conducted over three months (January to March 2012)
in North Gondar Zone. Twelve kebeles (clusters) were selected randomly from six districts to identify maternity
clients cared for by skilled providers. Then 12 health centers and 3 hospitals utilized by the corresponding cluster
population were selected for facility survey. Interview with facility managers/heads, providers and clients and
observations were used for data collection. Data were entered using Epi Info and were exported to SPSS software
for analysis.
Results:
Antenatal and delivery care were available in most of the visited facilities. However, the majority of them
were not fully functioning for EmOC according to their level. Signal functions including administration of
anticonvulsants and assisted vaginal delivery were missing in seven and five of the 12 health centers, respectively.
Only one hospital met the criteria for comprehensive emergency obstetric care (performed cesarean section). Only
24% of the providers used partograph consistently. About 538 (32.3%) and 231 (13.8%) of the women received
antenatal and delivery care from skilled providers, respectively. Most of the services were at health centers by
nurses/midwives. At the time of the antenatal care, women received the important components of the services
(percentage of users in bracket) like blood pressure checkup (79%), urine testing (35%), tetanus immunization (45%),
iron supplementation (64%), birth preparedness counseling (51%) and HIV testing (71%). During delivery, 80% had
their blood pressure measured, 78% were informed on labor progress, 89% had auscultation of fetal heartbeat, 80%
took drugs to prevent bleeding and 78% had counseling on early & exclusive breast-feeding.
Conclusion:
Antenatal and delivery care were available in most of the visited facilities. However, important
components of both the routine and emergency maternity care services were incomplete. Improving the functional
capacity of health facilities for the delivery of routine maternity and EmOC services are needed.