UPGRADING OBSTETRIC CARE AT A SECONDARY REFERRAL HOSPITAL, OGUN STATE, NIGERIA

Preliminary studies: A 1991 inventory at the State Hospital, Ota, in O gun State, Nigeria, showed inadequate surgical equipment, drugs, blood and power supply. A time-motion study indicated substantial delays in receiving obstetric care. Interventions: In 1994, medical officers an d midwives were given refresher courses in emergency obstetric skills. In 1995, the surgical theater, labor ward and laboratory were provide d with the necessary supplies and equipment, A reliable electrical sup ply was set up, but problems were encountered in establishing blood se rvices. Subsequent community interventions focused on improving access and reducing delay in seeking care. Results: The annual number of wom en with complications seen, which had been declining - from 123 in 199 2 to 55 in 1994 - increased to 91 in 1995. Case fatality rate (CFR) du e to major direct obstetric complications did not change appreciably, i.e. it was 6.6% in 1995, as compared with 7.3%, 8.3% and 7.3% for the years 1992-1994, respectively. Costs: The cost of hospital improvemen ts was approximately US $46000. Conclusions: The facility improvements were completed only recently in mid-1995. It is hoped that improved s ervices will result in reductions in CFR and motivate more women with complications to seek hospital care, despite difficult economic condit ions prevailing in Nigeria. (C) 1997 International Federation of Gynec ology and Obstetrics.