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MAJOR OBSTETRIC INTERVENTIONS AMONG EIQCAMPED REFUGEES AND THE LOCAL POPULATION IN TURKANA DISTRICT, KENYA
Abstract
Background: Maternal mortality in developing countries remains high due to lack of
appropriate emergency obstetric care. Major obstetric intervention (MOI) rate can be used
as an indicator of unmet obstetric needs and quality of care.
Objectives: Identify indications for major obstetric interventions, determine M01 rates and
assess extent of unmet obstetric need for women in Turkana district, Kenya.
Design: Descriptive bi-directional study.
Setting: Turkana district: Kakuma Refugee Camp, Kakuma Catholic Mission and Lodwar -
District Hospitals.
Subjects: Four thousand two hundred and eighty encamped refugee women and 7,630
women from the host population delivering in Turk ma district between January 1995 and
September 1999.
Data Sources: Maternity registers, inpatient case notes and theatre registers.
Main outcome measures: Maternal mortality, perinatal mortality, major obstetric
interventions, unmet obstetric need and length of st ty.
Results: The subjects from the two study populations were similar with respect to age, parity
and indications for surgical intervention. Caesarea~t section was the only major obstetric
intervention. Overall, caesarean section rate was sig iificantly higher among refugees than
in the host population (3.1 % versus 2.1 % , p<O.Ol; CI 1.4-2.1). Maternal indications were the
main reasons for CIS in both populations, with the ds rate being higher for refugees than for
local women (2.5% versus 1.7%). At least 0.8% of parturient women from the host
population had unmet obstetric needs: this translata to 61 pregnant women who may have
died or experienced birth-related complications over the study period. The mean length of
hospital stay was much less for refugee women than fc r the host population (8.1 days versus
11.3 days).
Conclusion: Encamped refugee women in Kakuma lave better obstetric care than those
from the host population, and the level of unmet obst 3tric needs in the district is high. This
imbalance could be reduced through resource sharing and integration of refugee health care
services with that for the host population.
appropriate emergency obstetric care. Major obstetric intervention (MOI) rate can be used
as an indicator of unmet obstetric needs and quality of care.
Objectives: Identify indications for major obstetric interventions, determine M01 rates and
assess extent of unmet obstetric need for women in Turkana district, Kenya.
Design: Descriptive bi-directional study.
Setting: Turkana district: Kakuma Refugee Camp, Kakuma Catholic Mission and Lodwar -
District Hospitals.
Subjects: Four thousand two hundred and eighty encamped refugee women and 7,630
women from the host population delivering in Turk ma district between January 1995 and
September 1999.
Data Sources: Maternity registers, inpatient case notes and theatre registers.
Main outcome measures: Maternal mortality, perinatal mortality, major obstetric
interventions, unmet obstetric need and length of st ty.
Results: The subjects from the two study populations were similar with respect to age, parity
and indications for surgical intervention. Caesarea~t section was the only major obstetric
intervention. Overall, caesarean section rate was sig iificantly higher among refugees than
in the host population (3.1 % versus 2.1 % , p<O.Ol; CI 1.4-2.1). Maternal indications were the
main reasons for CIS in both populations, with the ds rate being higher for refugees than for
local women (2.5% versus 1.7%). At least 0.8% of parturient women from the host
population had unmet obstetric needs: this translata to 61 pregnant women who may have
died or experienced birth-related complications over the study period. The mean length of
hospital stay was much less for refugee women than fc r the host population (8.1 days versus
11.3 days).
Conclusion: Encamped refugee women in Kakuma lave better obstetric care than those
from the host population, and the level of unmet obst 3tric needs in the district is high. This
imbalance could be reduced through resource sharing and integration of refugee health care
services with that for the host population.
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