Abstract
Objective: To assess changes in readiness to provide emergency obstetric and newborn care (EmONC) in health facilities in Afghanistan between 2010 and 2016. Methods: A secondary analysis was performed of a subset of data from cross-sectional health facility assessments conducted in December 2009 to February 2010 and May 2016 to January 2017. Interviews with health providers, facility inventory, and record review were conducted in both assessments. Descriptive statistics and χ2 tests were used to compare readiness of EmONC at 59 public health facilities expected to provide comprehensive EmONC. Results: The proportion of facilities reporting provision of uterotonic drugs, anticonvulsants, parenteral antibiotics, newborn resuscitation, and cesarean delivery did not change significantly between 2010 and 2016. Provision of assisted vaginal deliveries increased from 78% in 2010 to 98% in 2016 (P<0.001). Fewer health facilities had amoxicillin (61% in 2016 vs 90% in 2010; P<0.001) and gentamicin (74% in 2016 vs 95% in 2010; P<0.002). The number of facilities with at least one midwife on duty 24 hours a day/7 days a week significantly declined (88% in 2016 vs 98% in 2010; P=0.028). Conclusion: Despite a few positive changes, readiness of EmONC services in Afghanistan in 2016 had declined from 2010 levels.
| Original language | English |
|---|---|
| Pages (from-to) | 361-368 |
| Number of pages | 8 |
| Journal | International Journal of Gynecology and Obstetrics |
| Volume | 148 |
| Issue number | 3 |
| Early online date | 7 Dec 2019 |
| DOIs | |
| Publication status | Published - Mar 2020 |
Funding
The authors thank UNICEF and the US Agency for International Development (USAID) for funding the study and technical collaboration, central and provincial Ministries of Public Health for their guidance and support, the non‐governmental organizations implementing Afghanistan's healthcare services, and those professionals who participated in the study. Special thanks to Malalai Naziri, Ariel Higgins‐Steele, and Shirin Varkey from UNICEF; Sher Shah Amin from USAID; Sayed Attalla Saeedzai, MoPH General Director of Evaluation and Health Information System; Catherine Todd, Reproductive, Maternal, Newborn Child Health Division; and Patsy Bailey, Senior Scientist Health Services Division, FHI360; Faridullah Atiqzai, Zahra Sultani, Sayed Esmati, Ahmad Eklil Husain, Mahmood Azimi, Enayatullah Mayar, Abdul Qader Rahimi, Raouf Saidzadah, Matiuallah Noorzad, and Laila Natiq from Jhpiego Afghanistan; Sheena Currie, Elizabeth Sasser, and Grace Jacoby from Jhpiego/Baltimore; facility staff participating in the study; and women allowing observation of care. Thanks to all the midwives and doctors who served as data collectors in very difficult situations. Funding for the 2010 Emergency Obstetric and Newborn Care Needs Assessment was provided by UNICEF Afghanistan. Funding for the 2016 Maternal and Newborn Health Quality of Care Assessment was provided by USAID Afghanistan FP/MNCH Project (AID‐306‐A‐15‐00002) and UNICEF Afghanistan. The contents of this manuscript are the responsibility of the authors and do not necessarily reflect the views of the funders.
Keywords
- Afghanistan
- Emergency obstetric and newborn care
- Health facility assessment
- Health facility readiness
- Maternal health
- Newborn health
