Student
Dissertation 1st Batch 
ASSESSING THE QUALITY OF CLINICAL CARE OF EmOC IN A UPAZILLA HEALTH COMPLEX OF BANGLADESH
“WHERE WILL THEY GO?”
Nusrat Homaira
Abstract
Every year over half a million women die globally from causes related to pregnancy and childbirth, with over 99% of these deaths occurring in developing countries and in Bangladesh the maternal mortality ration (MMR) is currently 320/100000 live births. Majority of maternal deaths are due to direct obstetric complications like hemorrhage, sepsis, complications of abortion, hypertensive disorders of pregnancy, prolonged/obstructed labor, ruptured uterus and ectopic pregnancy.
In 1993 UNICEF Bangladesh was the first UN agency to take up Emergency Obstetric Care (EmOC) program through the existing GOB (Government of Bangladesh) health infrastructure in primary, secondary and tertiary hospitals. Today we have 190 EmOC facility supported by UNICEF. Over the past decade Bangladesh has done substantial progress in reducing the maternal mortality ratio but is still very high. Unless enough facilities provide emergency obstetric care to women who need it, women will still die regardless. At the same having enough facilities with EmOC does not automatically ensure quality care and many problems can be attributed to the poor care women receive after reaching the facility.Quality assurance is put into practice through guidelines such as policies, standards, protocols and procedures that govern day-to-day operations. Standards specify qualifications and acceptable levels of performance for providers and protocols give providers step-by-step instructions for performing their tasks. Evidence-based best practices not only increase client satisfaction but also maintain a high utilization rate. Improving the quality of care does not cost a lot of money and no matter the level of resources, the quality can always be improved and is usually cost-effective. Thus this research examined the extent to which evidence based best practices are being followed in a clinical setting of EmOC in one of the Upazilla health complexes of Bangladesh, which is extremely crucial to improve utilization of service which inturn will influence the maternal mortality in our country.
