TitleEmergency Obstetrical and Neonatal Capacity and Health Center Access in Kalomo District, Zambia
AuthorsHamer DH, Semrau K, Everett LL, Mazimba A, Seidenberg P, Goggin C, Yeboah-Antwi K, Herlihy J, Sialubanje C, Musoktwane K, Thea D, Spear C, Grogan C, Maine D, Gopal S.
Presented toSecond Global Symposium on Health Systems Research


Ensuring pregnant women deliver at health facilities with skilled attendants is a major strategy for improving the survival and health of mothers aud newborns. We examined the availability of emergency obstetrical and neonatal care (EmONC) and accessibility of health facilities using GIS (geographic information system) in a rural Zambian district.


Comprehensive health facility surveys were Kalomo District, Zambia (total population 264,634). The United Nations indicators for basic and comprehensive EmONC were used to characterize health facilities' capacity. GIS analyses were performed to discover spatial patterns and evaluate transport network effectiveness between health centers and referral hospitals.


35 health facilities (2 referral hospitals; 33 primary health centers) were surveyed. Only 51% of the facilities had electricity, 20% had running water, and none had functional radios for communication although 94% had a facility or personal mobile phone available. Less than half (43%) of facilities had EmONC-trained medical personnel and only three (8.6%) had full EmONC capacity (two basic, one comprehensive). These were located in Kalomo's largest urban health facilities situated -40 km apart. At a 30 km distance lag, buffers surrounding the facilities (n31 with GIS data) include 11 centers administering minimal levels of emergency delivery care and the three urban EmONC facilities. The remaining 60% of the district's health centers are located>30 km from these health facilities. While primary and secondary road networks cover most of Kalomo's territory, isolated pockets remain unserved. Motorized ambulatory transport options were available at only three facilities located in the district's two largest towns. Conclusions: Quality and availability of EmONC  in this rural Zambian district were limited. The clustered distribution of EmONC health facilities in the most populated urban centers provides professional medical assistance for immediate surrounding communities, but leaves the majority of the population without EmONC access.
Related ProjectsSaving Mothers Giving Life (SMGL)