Effect of emergency obstetrics and neonatal care services on maternal and neonatal mortalities at the kumba health district

CaHReF 2016, Yaoundé Conges hall, 23 – 26 August 2016 , PP05

The Emergency Obstetrical and Neonatal Care services (EmONC) were instituted in Cameroon in 1995 as a strategy for maternal and newborn mortality reduction. Trends in maternal/Neonatal mortality in Cameroon show a rise from 2004 to 2011 in spite of EmONC. Thus, we undertook this study to evaluate the EmONC project in the Kumba heath district. General objective Evaluate the EmONC services in terms of maternal/ neonatal mortality at the kumba health district.  Specific objectivesTo assess the availability of EmONC servicesTo assess the utilization of Em ONC services To assess the quality of EmONC servicesTo determine the association between EmONC and maternal/neonatal mortality

This was a cross sectional study with retrospective data collection, from 2009 to 2014; data collection was in September 2015 using a questionnaire and a data grid. Maternal/neonatal mortalities were examined 2 years before EmONC, 2 years after and 4 years after EmONC.Data was analysed using Epi-Info 3.5 statistical software.
9 EmONC health facilities were evaluated within which 21029 deliveries, 70 maternal deaths (3.33‰) and 529 neonatal deaths were registered (2.51%). 17 maternal deaths (25.7%) and 111 neonatal deaths were recorded (20.9%); two years after EmONC, 20 maternal deaths (27.1%) and 245 neonatal deaths were registered (46.3%); and 4 years after EmONC, the maternal and neonatal deaths were 33 (47.4%) and 173(32.7%) respectively. We found no association between the practice of EmONC and maternal/neonatal mortalities (OR=2.16, p value=0.2146 CI=0.0335-7.4519). But the low quality of EmONC services (increase deaths from direct obstetrical complications) was associated with a high neonatal mortality rate (OR=1.0304, p=0.005 CI=0.9945-1.0676). The number of Post-partum hemorrhage steadily increased and was the leading cause of maternal mortality 60(2009-2010), 160(2011-2012) and 180(2013-2014).). 

Maternal/neonatal mortalities remain unacceptably high despite the institution of EmONC service in the Kumba Health District. This is could be as a result of the program training the wrong profile staff and inadequate equipment in EmONC facilities. There is a need for correct profile trained staff and well equipped EmONCs facilities.

EmONC, maternal death, neonatal death, evaluation