Emergency obstetric care in Pakistan: potential for reduced maternal mortality through improved basic EmOC facilities, services, and access

Int J Gynaecol Obstet. 2005 Oct;91(1):105-12. doi: 10.1016/j.ijgo.2005.03.034.


Objective: To ascertain and compare compliance with UN emergency obstetric care (EmOC) recommendations by public health care centers in Pakistan's Punjab and Northwest Frontier Province (NWFP) provinces.

Method: Cross-sectional data were collected from July through September 2003 using UN process indicators. From each province, 30% of districts (n=19); were randomly selected; all public health facilities providing EmOC services (n=170) were included.

Results: The study found that out of 170 facilities only 22 were providing basic and 37 comprehensive EmOC services in the areas studied. Only 5.7% of births occurred in EmOC health facilities. Met need was 9% and 0.5% of women gave birth by cesarean section. The case fatality rate was a low 0.7%, probably due to poor record keeping. Access and several indicators were better in NWFP than in Punjab.

Conclusion: Almost all indicators were below UN recommendations. Health policy makers and planners must take immediate, appropriate measures at district and hospital levels to reduce maternal mortality.

MeSH terms

  • Cross-Sectional Studies
  • Delivery, Obstetric
  • Emergency Medical Services*
  • Female
  • Health Services Accessibility
  • Health Services Needs and Demand
  • Humans
  • Maternal Health Services / standards*
  • Maternal Health Services / statistics & numerical data
  • Maternal Mortality
  • Maternal Welfare
  • Obstetrics / standards*
  • Pakistan / epidemiology
  • Pregnancy
  • Prenatal Care
  • Public Health Administration / standards
  • United Nations