Myanmar Health Sciences Research Journal
Volume 29, Number 3
TITLE: Current Practices and Problems Encountered in Emergency Obstetric Care in Rural Areas of Central Myanmar
AUTHOR: Kyaw Oo, Tin Tin Wynn, Theingi Myint, Thandar Myint, Zaw Ye Naing & Bo Lin
SOURCE: Myanmar Health Sciences Research Journal, Vol. 29, No. 2, 2017
ABSTRACT: Complications during pregnancy and childbirth are a leading cause of mortality among reproductive age women in Myanmar. There is little documented experience of the emergency obstetric care (EmOC) and problems encountered at first-level maternal care services in rural areas where MMR (136 per 100,000 live births) is higher than national average. Cross-sectional descriptive study using quantitative and qualitative methods was conducted at Myingyan and Kyaukpadaung townships in Mandalay Region. One hundred and nine midwives (MW), 2 township medical officers, 4 health assistants, 12 under-one mothers, 8 community key informants participated. Majority of midwives (MW) were providing antenatal care services to average 1 to 10 women monthly. One MW attended five deliveries per month in average. Referral rate was 27% of deliveries. Compliance rate of the referral was 71%. Most of maternal deaths occurred during deliveries at home and nearly half were attended by skilled attendants or traditional birth attendants or both post-partum hemorrhage and eclampsia caused two-third of all deaths. Most frequently faced emergency obstetric problems were abnormal foetal position and obstructed labour and PPH. Most frequent referrals were with obstetric history of primigravida (60%), elderly gravida (38%) and multiparity (23%). Common obstetric emergencies were prolong labour (45%), eclampsia (27%) and obstructed labour (22%). Thirty percent of MWs who had experienced of emergency problem could not provide some BEmOC services such as oxytocin injection, manual removal of retained placenta and mucous suction for neonate although they perceived they should provide those services. The existing maternal referral system in rural areas needs to be more effective for timeliness and good compliance. MWs’ Basic EmOC skill in rural areas should be improved by strengthening training, guidance and supervision.
SUBJECT HEADINGS: Emergency obstetric care, Rural, Referral