Availability, utilization, and quality of emergency obstetric care services in Bauchi State, Nigeria

OBJECTIVE: To report the availability, utilization, and quality of emergency obstetric care (EmOC) services in Bauchi State, Nigeria. METHODS: Between June and July 2012, a cross-sectional survey of health facilities was conducted. Data on the performance of EmOC services between June 2011 and May 2012 were obtained from records of 20 general hospitals and 39 primary healthcare centers providing delivery services. Additionally, structured interviews with facility managers were conducted. RESULTS: Only 6 (10.2%) of the 59 facilities met the UN requirements for EmOC centers. None of the three senatorial zones in Bauchi State had the minimum acceptable number of five EmOC facilities per 500 000 population. Overall, 10 517 (4.4%) of the estimated 239 930 annual births took place in EmOC facilities. Cesarean delivery accounted for 3.6% (n=380) of the 10 517 births occurring in EmOC facilities and 0.2% of the 239 930 expected live births. Only 1416 (3.9%) of the expected 35 990 obstetric complications were managed in EmOC facilities. Overall, 45 (3.2%) of 1416 women with major direct obstetric complications treated at EmOC facilities died. Among 379 maternal deaths, 317 (83.6%) were attributable to major direct obstetric complications. CONCLUSION: Availability, utilization, and quality of EmOC services in Bauchi State, Nigeria, are suboptimal. The health system's capacity to manage emergency obstetric complications needs to be strengthened.