Situation analyses of management of emergency obstetric complications at Muhimbili National Hospital.

Background. Arriving at the facility providing a comprehensive emergency obstetric care may not lead to immediate commencement and receipt of correct treatment. Congestion of patients, shortage of qualified staff, shortage of essential drugs and supplies coupled by administrative delays and clinical mismanagement are documentable contributing delays in starting correct treatment. Objectives. The aim of this study was to analyse the management of emergency obstetric complications in Muhimbili National Hospital. Methodology. It is an observational cross section study. A total of 250 pregnant women who were admitted in the labour ward at Muhimbili National Hospital with obstetric complications or who developed complications after admission during the period of study were included. The data was obtained through observation, from partograms, clinical notes and antenatal cards. Results. This study showed that, there was delay in initiating treatment after the patient had been admitted. The mean time interval from admission to the time the patient was seen by a doctor was 2 hours 45 minutes with a periods as long as 17 hours. However being seen by a doctor did not guarantee the patient being given treatment, for example the mean time interval from decision making and starting of an operative procedure was 3 hours and 30 minutes. Blood for transfusion was not available to 34% of the patients who needed blood transfusion. Majority of those who got blood had to wait for more than 2 hours before getting blood. Conclusion. The study found that there were delays in making decisions and starting treatment. These delays are likely to contribute to the maternal morbidity and mortality that occur at Muhimbili National Hospital.