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dc.contributor.authorNganjo Phiri, Seliaen_US
dc.contributor.authorFylkesnes, Knuten_US
dc.contributor.authorMoland, Karen Marieen_US
dc.contributor.authorByskov, Jensen_US
dc.contributor.authorKiserud, Torviden_US
dc.date.accessioned2016-12-30T10:02:52Z
dc.date.available2016-12-30T10:02:52Z
dc.date.issued2016-01-29
dc.PublishedPLoS ONE 2016, 11(1):e0145196eng
dc.identifier.issn1932-6203
dc.identifier.urihttps://hdl.handle.net/1956/15309
dc.description.abstractBackground: Zambia has a high maternal mortality ratio, 398/100,000 live births. Few pregnant women access emergency obstetric care services to handle complications at childbirth. We aimed to assess the deficit in life-saving obstetric services in the rural and urban areas of Kapiri Mposhi district. Method: A cross-sectional survey was conducted in 2011 as part of the ‘Response to Accountable priority setting for Trust in health systems’ (REACT) project. Data on all childbirths that occurred in emergency obstetric care facilities in 2010 were obtained retrospectively. Sources of information included registers from maternity ward admission, delivery and operation theatre, and case records. Data included age, parity, mode of delivery, obstetric complications, and outcome of mother and the newborn. An approach using estimated major obstetric interventions expected but not done in health facilities was used to assess deficit of life-saving interventions in urban and rural areas. Results: A total of 2114 urban and 1226 rural childbirths occurring in emergency obstetric care facilities (excluding abortions) were analysed. Facility childbirth constituted 81% of expected births in urban and 16% in rural areas. Based on the reference estimate that 1.4% of childbearing women were expected to need major obstetric intervention, unmet obstetric need was 77 of 106 women, thus 73% (95% CI 71–75%) in rural areas whereas urban areas had no deficit. Major obstetric interventions for absolute maternal indications were higher in urban 2.1% (95% CI 1.60–2.71%) than in rural areas 0.4% (95% CI 0.27–0.55%), with an urban to rural rate ratio of 5.5 (95% CI 3.55–8.76). Conclusions: Women in rural areas had deficient obstetric care. The likelihood of under-going a life-saving intervention was 5.5 times higher for women in urban than rural areas. Targeting rural women with life-saving services could substantially reduce this inequity and preventable deaths.en_US
dc.language.isoengeng
dc.publisherPLOSeng
dc.relation.haspart<a href="http://hdl.handle.net/1956/10777">http://hdl.handle.net/1956/10777</a>en_US
dc.rightsAttribution CC BYeng
dc.rights.urihttp://creativecommons.org/licenses/by/4.0eng
dc.titleRural-urban inequity in unmet obstetric needs and functionality of emergency obstetric care services in a Zambian districten_US
dc.typePeer reviewed
dc.typeJournal article
dc.date.updated2016-12-13T13:47:07Z
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright 2016 The Author(s)
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0145196
dc.identifier.cristin1366128


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