Background
Methods
Study setting
Characteristics | Madhya Pradesh | District 1 | District 2 | District 3 |
---|---|---|---|---|
Population (in millions)a
| 72.0 | 1.9 | 1.02 | 1.07 |
Proportion rural populationa
| 68.0 | 58.0 | 88.0 | 71.0 |
Birth rate per 1000b
| 24.8 | 24.0 | 31.5 | 24.2 |
Institutional delivery %b
| 76.0 | 81.0 | 72.0 | 58.0 |
Human Development Index 2007c
| 0.4 | 0.6 | 0.5 | 0.6 |
MMRa
| 277.0 | 206 | 386.0 | 415.0 |
Data collection
Assessing EmOC signal functions and classifying facilities
Classifying facilities
Analysis
Ethical approval
Results
Facility characteristics
Programme facilities | ||||||
---|---|---|---|---|---|---|
Number of facilities | Deliveries conducted | Total bed strength | Skilled birth attendants | |||
Obstetrician/Gynaecologistb
| Non specialist Doctors | Nurses/ANM | ||||
Facility level | n | n | n | n | n | n |
CEmOC | 1 | 642 | 30 | 2 | 3 | 7 |
Less-than- CEmOC | 4 | 4502 | 270 | 2 | 8 | 34 |
Less-than- BEmOC | 113a
| 10157 | 668 | 5 | 105 | 338 |
Total | 118 | 15301 | 968 | 9 | 116 | 379 |
Non-programme facilities | ||||||
---|---|---|---|---|---|---|
Number of facilities | Deliveries conducted | Total bed strength | Skilled birth attendants | |||
Obstetrician/Gynaecologista
| Doctor | Nurse/ANM | ||||
Facility level | n | n | n | n | n | N |
CEmOC | 5 | 1002 | 148 | 38 | 26 | 24 |
Less-than-CEmOC | 25 | 1380 | 298 | 20 | 50 | 99 |
Less-than- BEmOC | 4 | 32 | 48 | - | 7 | 11 |
Total | 34 | 2414 | 494 | 58 | 83 | 134 |
Distribution of births by facility type (programme/non-programme) and level of EmOC provision
Facility level | Programme (n = 15301) | Private (n = 2414) | Total (n = 17715) |
---|---|---|---|
CEmOC | 4 % | 42 % | 9 % |
Less-than-CEmOC | 30 % | 57 % | 33 % |
Less-than-BEmOC | 66 % | 1 % | 58 % |
Total | 100 % | 100 % | 100 % |
Bed strength
Human resources
The availability of EmOC
Indicator source | WHR 2005 benchmark | District 1 | District 2 | District 3 |
---|---|---|---|---|
Births per yearc
| 47760 | 32130 | 25894 | |
Required CEmOC facilities | At least 1 per 3600 births | 13–14 | 8–9 | 7–8 |
Total CEmOC facilities | 5 | 1 | 0 | |
Programme CEmOC facilities | 0 | 1 | 0 | |
Staffing | ||||
Required midwives as per standard | 20 midwives per 3600 births | 265 | 178 | 144 |
Available midwives (equivalent) | 207 | 118 | 188 | |
Required doctors as per standard | 3 doctors part-time per 3600 births | 41 | 27 | 22 |
Total available doctors | 183 | 35 | 88 | |
Obstetricians/Gynaecologists | 54 | 2 | 11 | |
Doctors | 99 | 31 | 69 | |
Proportion of births needing CEmOC | 17–18 % | |||
Proportion of births in CEmOC facilities | ||||
Total | 49 % | 14 % | 0 % | |
Programme | 0 % | 14 % | --- | |
Non-programme | 49 % | 0 % | --- | |
Births per midwife/equivalent per yeara
| 175 | |||
At CEmOC level | 165 | 368 | - | |
At less-than-CEmOC level | 169 | - | 201 | |
At less-than-BEmOC level | 117 | 147 | 96 | |
Complicated births per doctor (specialist) | 200 |
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