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Unmet Obstetric Need in Emergency Obstetric Services in Debre Berhan Referral Hospital, North Shoa Zone, Amhara Regional State, Ethiopia, 2021

Shambel Mengesha Kebede*, Wassie Negash Mekonnen

Background: Complications and obstetric emergencies were taken as an indicator of obstetric need. Obstetric needs are a health problem that needs emergency obstetric intervention. The assessment of unmet obstetric need has never been articulated in studies conducted on emergency obstetric care in the study area. This study identifies gap and deficit of major obstetric intervention for absolute maternal indication in relation to the existing need.

Method: A one year facility based cross-sectional retrospective study was conducted from July 8/2019-July 7/2020 G.C on mothers who delivered with major obstetric intervention (absolute maternal indication and non-absolute maternal Indication) at Debre Berhan referral hospital. Data was collected using structured and pre-tested format by four midwife trained data collectors from patient medical records. Rates of major obstetric interventions performed for absolute maternal indications among all expected births was calculated to assess unmet obstetric need. Training and using structured format were used to ensure the data quality in addition to supervision.

Result: A total of 363 major obstetric interventions were conducted in the study area. The result revealed that the unmet obstetric need of the area was 31.4%. Caesarean sections took the largest share of major obstetric interventions 358 (98.6%). Out of 153 women with absolute maternal indications majority were cephalo-pelvic disproportion which account 87 (24%). The number of major obstetric interventions done without absolute maternal indications was 210 (57.8%) where majority 78 (29.5%) were done for fetal distress.

Conclusion and recommendation: There was higher unmet obstetric needs in rural than urban areas. Even though maternal mortality has been declining and no death was observed. The caesarean section rate was 2.3% this was below the world health organization recommendation 5% to 15%. Estimating the amount of unmet need for major obstetric interventions provide the information necessary for planning and prioritizing the development of services; and lead to action for the reduction of maternal mortality at local level.