THE OBSTETRIC KITS PROGRAM
AIM: To contribute in reducing maternal and neonatal mortality in the North-West Region of Cameroon
Context and Justification
The millennium development goal (MDG) 5, to improve on maternal health has as one of its targets to reduce by three quarters, between 1990 and 2015, the maternal mortality ratio. According to trends in maternal mortality, an estimated 287,000 maternal deaths occurred globally in 2010. In Cameroon, Maternal mortality ratio has been on a constant increase during the last decade; from 669 maternal deaths per 100 000 live births in 2004 to 782 per 100 000 live births in 2011. (DHS III, DHS IV).
Maternal death is defined as the death of a woman while pregnant or within 48 hours of termination of pregnancy. The cause could be directly obstetric due to obstetrical complication or indirectly obstetric from a previously existing disease or a disease developed during pregnancy. Direct causes of maternal mortality include hemorrhage, infection, eclampsia or severe pre-eclampsia, dystocia and unsafe abortions. For everyone woman who dies of a pregnancy related complication, 20 to 30 others have complications, with obstetric fistula being the worst.
Three deadly Lateness were identified as the cause of the increase in maternal mortality namely: Lateness in health seeking decision, Lateness in transferring woman to the health unit and lateness in case management upon arrival at the health facility.
Within the framework of reducing maternal mortality in the North-West region, the Obstetric Kits Project was designed to put in place obstetric kits in 30 public health facilities and 5 confessional health facilities in the North-West region in 2013 to rapidly take care of deliveries and all related complications. The intention was to introduce the strategy in these health facilities and later scale up to all other health facilities in the region.
A functional referral system to reduce lateness in transferring clients to health units was put in place in some regions in Cameroon, including the North West. This involved the provision of medical equipment and moto-ambulances to some 6 health facilities in the region, provision of cell phones and sim cards and training moto-ambulance riders.
Health staffs have also been trained to offer adequate quality health care to mothers and new born babies.
The program which started since 2013 has enjoyed the sponsorship of the Ministry of Public Health (MOH), GIZ and the community
Pregnant women who are members of Mutual Health Organization are given free delivery or Caesarean Section kit at labour
What is an Obstetric Kit?
It is a kit of all necessary items needed by a woman during either normal delivery or caesarean section. These items are grouped and packaged to make a Delivery Kit or the Caesarean Section Kit.
The Delivery Kit is sold at 6000 FCFA and contain the essential items needed to conduct a normal delivery
The Caesarean Section Kit is sold at 40 000 FCFA and has all the items required to carry out a caesareab section delivery.
Why the Obstetric Kits Program?
- To reduce waiting time at arrival in a health facility
- To facilitate and reduce financial barrier in the of delivery complications like tears, infections, post-partum haemorrhage, eclampsia, dystocia
- To cause a systematic education and awareness creation for pregnant women on preparedness before labour through the Birth Plan.
- To create community awareness on the importance of using the health facility through the Dialogue Structure Members
When did the program begin?
- The Obstetric kit Program started in the North West Region in 2013 with the objective to increase the percentage of deliveries conducted by qualified personnel by 15% and to increase the rate of C-Section by 5%
How Much does the Obstetric Kit Cost
- Delivery Kit = 6000 FCFA
- Caesarean Section Kit (General Anaesthesia) = 25 000FCFA
- Caesarean Section Kit (Spinal Anaesthesia) = 34 000FCFA
- Emergency boxes containing medicines provided to health facilities by NWRFHP for free management of 4 major of delivery complications namely: Infections, tears, post-partum haemorrhage and eclampsia.
- No payment of bed fees no matter the number of days spent in the health facility before and after delivery.
What is the benefit to a pregnant woman?
There are lots of benefits from the Obstetric Kits more than direct payment of a delivery bill. Some benefits are cited below:
- Free treatment of delivery complications
- No other charge and no payment of bed fees
- Benefit from delivery plan and proper counselling
- Benefit from the effective use of the partograph to monitor progress of labour so that the best decision should be taken during that critical time
- Your delivery medical needs are already in tack
How does the Obstetric Kits Program operate?
- Kits are supplied to the health unit pharmacy by the NWRFHP
- Items in the emergency box for the management of delivery complications are deposited at the maternity for easy quick access to handle emergencies by NWRFHP
- A pregnant woman on labour arrives the maternity, buys either a normal delivery kit or a caesarean section kit depending on medical advice
- Tools like birth plans, report forms and partographs etc. are also deposited at the health facility to be used by health personnel
Where Does the Obstetric Kits operate?
- All Government health centres
- All Government hospitals
- Mission health facilities, private hospital and clinics that are in the program
When can a pregnant woman benefit from this program
- When she goes for ANC and deliver in the hospital or health centre mentioned above
When does the health personnel use the tools?
- The Birth Plan is used at ANC
- The Partograph is used during labour
- The free medicines are used in case of complication
- The Reporting Form is filled and submit at the end of the month
How is the Program evolving over the years?
- As of November 2020, the are 284 trained health facilities in the program constituting 207 public health facilities, 71 confessional health facilities, 6 private health facilities from the 35 health facilities in 2013
- Many health facilities in the region were trained in 2017 and 2018 on Emergency Obstetric and Neonatal Care
- The program has co-opted different health actors in a rotatory manner e.g District Medical Officers, Chief of Centres, Administrators of confessional health facilities in to the Regional Evaluation Committee of the program which was not the case in 2013.
- From the request of health facilities, a new type of kit (the C-Section Kit with Spinal Anaesthesia has been made available since 2018) which is not the case at inception in 2013.
- Supportive supervision of health facilities every year
- Feedback is given to health facilities concerning the activities of the program
What is the impact of the Kits program today?
- The good news is that in the NIS release dated 4th of November 2019, the MMR has reduced from 784 maternal deaths per 100,000 live births in 2011 to 467 in maternal deaths per 100,000 live births in 2018 (40% decrease). But this is still 10 to 20 times higher than the MMR in some Developing Countries.
- Decrease in maternal and neonatal deaths in participation health facilities is as follows:
For more Information and inquiries contact the nearest health facility
or call 676376940/675398092