tatus of Emergency Obstetric and Newborn Care Services and Client Satisfaction among Public Health Facilities in Jimma Zone, Oromia Region, Ethiopia

Abstract

Background: United Nations Millennium Project of Transforming Health Systems for women & children report of 2005 concluded that universal access to EmONC could reduce maternal deaths by 74%. Even though there are some studies conducted in the country and outside the country towards the availability, utilization and quality of EmONC there is no similar studies conducted in Jimma zone. This study is aimed to the status of EmONC services among public Health Facilities in Jimma Zone, South West Ethiopia. Methods: A facility- based cross sectional study was conducted in Jimma Zone from April 01-30, 2014. Health care workers assigned on maternity ward, health facility in charge, referral focal person and client interview were done to obtain the required data. The sample size of the study was randomly selected 30 Health Centers and 4 hospitals in Jimma zone a total of 34 health facilities. Six persons were participated in data collection. Data was entered by using Epi info version 3.5.4, analyzed using SPSS version 20 for windows and presented with frequency distribution tables, graphs, charts and texts. Linear regression was done to ascertain the association between covariates and the outcome variable. Result: From 30 health centers and 4 hospitals assessed in this study, only 1 health center and 3 hospitals and a total of 4 (11.8%) health facilities qualified the requirements of EmONC facilities. For a population of 3,030,740 in Jimma zone, the estimated result is 3 BEmONC and 3 CEmONC health facilities a total of 6 EmONC facilities which is one sixth of the minimum acceptable level of ≥ 5 EmONC facilities per 500, 000 population. Regarding service utilization the proportion of all births in EmOC facilities is only 7 % and caesarean sections in EmOC facilities as a proportion of all births is 1.2% which is again below the minimum acceptable level of 5-15% births by cesarean section. The major reasons for health facilities not performing the signal functions are related to drugs, supplies, equipment and absence of indication. The overall proportion of client satisfaction is 79%. Conclusion: Based on the UN minimum requirements of availability of EmOC, a 3,030,740 population needs at least 6 CEmONC and 24 BEmONC health facilities. But, the estimated obtained result from this study shows only 3 CEmONC and 3 BEmONC which is much lower than the recommended standards. The utilization and quality of the existing services is also low which can be explained from proportion of deliveries in EmONC facilities and from client`s point of satisfaction. I