Professional Assessment of Emergency Obstetric Care Availability in Secondary Hospitals in Anambra State

Emergency obstetric care is a critical component of the continuum of maternal care, and the availability of signal functions for EmOC at secondary hospitals in south-eastern Nigeria determines the system's capacity to manage life-threatening obstetric complications. This study assessed emergency obstetric care availability and readiness at secondary hospitals in Anambra State, South East Nigeria. A health facility assessment design was employed across 12 secondary hospitals (General Hospitals and Comprehensive Health Centres) in Onitsha, Awka, and Nnewi Districts. The assessment applied the WHO/UNFPA EmOC assessment tool covering the nine basic and comprehensive EmOC signal functions, staffing availability, blood banking, referral system functionality, and case management record quality. Results showed that none of the 12 hospitals met criteria for comprehensive EmOC facility status. Six of nine basic EmOC signal functions were available in 58.3 percent of facilities. Surgical capacity (laparotomy, caesarean section) was present in only 33.3 percent. Blood banking services were available in 41.7 percent. Anaesthesia provider availability at night was confirmed in 25.0 percent of facilities. 24-hour obstetric coverage was maintained in 66.7 percent. Functional referral communication systems with tertiary facilities existed in 50.0 percent. The study concludes that EmOC service availability at Anambra secondary hospitals is critically deficient and recommends emergency obstetric care readiness investment as a state maternal health programme priority.

Keywords: emergency obstetric care, secondary hospitals, Anambra State, maternal health, signal functions