Search

Unsafe abortion is a leading cause of maternal mortality and morbidity worldwide. A total of 266 women seeking care at health facilities for the treatment of incomplete abortion in Tigray, Ethiopia were studied, and factors associated with severe complications related to unsafe abortion were assessed. Women had significantly higher odds of experiencing severe clinical complications if they were married compared with unmarried (odds ratio 3.98; 95% confidence interval, 1.75-9.04) or were seen in a mid- or low-level health facility (a health center or health post) compared with a high-level facility (a hospital) (odds ratio 4.77; 95% confidence interval, 1.87-12.19). The findings support the need to provide family planning programs that involve men and the need to expand access to confidential, safe abortion services by mid-level providers so that pregnancy termination no longer means placing women's lives and health in danger., (Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)

Objective: To assess the contribution of nonphysician clinicians (NPCs) to comprehensive emergency obstetric care (CEmOC) in Tigray, Ethiopia., Methods: We conducted a retrospective review of the obstetric records of all women treated from January 1, 2006, to December 31, 2008, at the 11 hospitals and 2 health centers with CEmOC status in Tigray. Data were collected using 2 questionnaires, one concerning the facility and the other concerning the patient., Results: During the studied period 25,629 deliveries and 11,059 obstetric procedures (3369 of which were major surgical interventions) were performed at these 13 institutions. Overall, NPCs performed 63.3% of these procedures, which included 1574 (55.5%) of a total of 2835 cesarean deliveries. Whereas the cesarean deliveries performed by physicians were more often elective, those performed by NPCs were more often indicated by an emergency. Maternal deaths, fetal deaths, and length of hospital stay did not statistically differ by type of attending staff., Conclusion: Not only do NPCs perform a significant proportion of emergency obstetric procedures in Tigray, but the postoperative outcomes achieved under their care are similar to those attained by physicians. Strengthening NPC training programs in emergency obstetric surgery should further reduce maternal and fetal mortality and morbidity in Ethiopia., (Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)