Monitoring and Evaluation Outcomes Associated With Strategies to Reduce the Third Delay in Uganda, 2011–2016 (N=105 facilities)
| Indicators | Baselinea Value | Endlinea Value | % Relative Changeb | Sig. Levelc |
|---|---|---|---|---|
| Strategy 1: Ensure facilities have adequate infrastructure to provide EmONC | ||||
| Total number of EMONC facilities | 10 | 25 | 150.0 | N/A |
| Number of CEmONC facilities | 7 | 17 | 142.9 | N/A |
| Number of BEmONC facilities | 3 | 8 | 166.7 | N/A |
| Deliveries in EmONC facilities | 28.2% | 41.0% | 45.4 | *** |
| Hospitals/health center IVs that perform blood transfusionsd | 56.3% | 100.0% | 77.6 | N/A |
| Hospitals/health center IVs that have capacity to perform surgery (caesarean-section)d | 50.0% | 100.0% | 100.0 | N/A |
| Facilities with electricity | 57.1% | 96.2% | 68.5 | *** |
| Facilities with water | 76.2% | 100.0% | 31.2 | N/A |
| Strategy 2: Ensure sufficient medical supplies and medications | ||||
| Facilities experiencing no stock-out of oxytocin in the past 12 months | 56.2% | 81.9% | 45.7 | *** |
| Facilities experiencing no stock-out of magnesium sulfate in the past 12 months | 47.6% | 63.8% | 34.0 | *** |
| Facilities reporting gentamycin antibiotic currently available | 90.5% | 88.6% | −2.1 | NS |
| Strategy 3: Ensure sufficient trained health care providers at facilities | ||||
| Facilities reporting at least 1 doctor, nurse, or midwife is on staff | 100.0% | 100.0% | 0.0 | NS |
| Health center IIIs that are open 24/7e | 74.6% | 82.9% | 11.1 | NS |
| Facilities reporting EmONC lifesaving interventions performed in the past 3 monthsf | ||||
| Parenteral antibiotics | 85.7% | 92.4% | 7.8 | NS |
| Parenteral oxytocin | 69.5% | 98.1% | 41.2 | *** |
| Parenteral anticonvulsants | 48.6% | 34.3% | −29.4 | ** |
| Manual removal of placenta | 28.6% | 54.3% | 89.9 | *** |
| Remove retained products | 19.0% | 61.9% | 225.8 | *** |
| Assisted vaginal delivery | 4.8% | 10.5% | 118.8 | NS |
| Newborn resuscitation | 34.3% | 87.6% | 155.4 | *** |
| Strategy 4: Improve quality of care and ensure care is evidence-based | ||||
| Facilities with protocols and guidelines available and displayed on EmONC lifesaving interventions | ||||
| AMTSL | 39.0% | 58.1% | 49.0 | *** |
| Postpartum hemorrhage | 15.2% | 85.7% | 463.8 | *** |
| Eclampsia or magnesium sulfate use | 8.6% | 74.3% | 764.0 | *** |
| Obstetric and newborn complications | 26.7% | 61.0% | 128.5 | *** |
| Immediate newborn care | 30.5% | 79.0% | 159.0 | *** |
| Facilities that report routine practice of partograph | 33.3% | 92.4% | 177.5 | *** |
| Facilities that report routine practice of AMTSL | 75.2% | 96.2% | 27.9 | *** |
| Facilities reporting that obstetric patients never share beds | 35.2% | 91.4% | 159.7 | *** |
| Facilities reporting that women never deliver on the floor | 85.7% | 91.4% | 6.7 | NS |
| Strategy 5: Ensure referral capacity to support transfers to higher-level care | ||||
| Facilities with at least 1 method of communication for referralsg | 93.3% | 99.0% | 6.1 | ** |
| Facilities that reported having available transportation (motor vehicle or motorcycle)h | 61.0% | 59.0% | −3.3 | NS |
| Strategy 6: Support effective maternal and perinatal health surveillance | ||||
| Facilities with maternal death reviews performed | 6.7% | 32.4% | 383.6 | *** |
| Hospital and health center IVs that performed maternal death reviewsd | 31.3% | 94.1% | 200.6 | *** |
↵a Baseline period was June 2011 to May 2012; endline period was January to December 2016.
↵b Percentage change calculations are based on unrounded numbers.
↵c Asterisks indicate significance levels calculated with a z-statistic using McNemar's as follows: *** = P<.01, ** = P<.05, NS = not significant. In cases where significance testing is not warranted, this is denoted as N/A.
↵d Hospital and health center IV was n=16 at baseline and n=17 at endline of HFA.
↵e Health center III was n=71 at baseline and n=70 at endline of HFA.
↵f Performance during the previous 3 months preceding the assessment.
↵g Includes facility owned landline, mobile phone, 2-way radio, or individual had a mobile phone.
↵h Includes available and functional motorized vehicle with fuel today and funds generally available.
Abbreviations: AMSTL, active management of the third stage of labor; BEmONC, basic emergency obstetric and newborn care; CEmONC, comprehensive emergency obstetric and newborn care; EmONC, emergency obstetric and newborn care; HFA, health facility assessments; N/A, not applicable; NS, not significant; Sig, significance.