It is within this context that the Women's Health and Action Research Centre (WHARC), a Nigerian national non-governmental organization is actively pursuing a series of implementation research activities aimed at improving the quality of BEmOC and CEmOC in the country.
A parallel study is also being undertaken by WHARC with funding from the International Development Research Centre (IDRC) (10), Canada to improve the use of Primary Health Centres (PHCs) by pregnant women and the quality of BEmOC offered by PHCs in Nigeria.
The clear message in this editorial is that there is a need to evolve an effective health system in African countries that provides composite BEmOC and CEmOC for dealing with obstetric emergencies that lead to maternal and neonatal mortality.
Figure 2) Egbeda, Ido, Oluyole and Ibarapa North local governments did not have any facility meeting either the BEmOC or CEmOC minus 1 criteria.
This shows that the coverage of BEmOC in the 13 local governments ranged from 0-5.
The results illustrated a continued lack of simple care package of life saving interventions (EmOC) as fully functional BEmOC facilities were almost non- existent in the sixty one primary health care facilities visited although CEmOC facilities were adequate in number.
In a baseline assessment of EmOC facilities in four African countries (Uganga, Kenya, Southern Sudan and Rwanda) by Pearson et al, it was found that the number of CEmOC facilities were more than the recommended minimum while the number of BEmOC facilities in all the four countries were below the recommended minimum (15).
The findings in this study also corroborates a previous study covering 12 States across the 6 geopolitical zones of Nigeria where only one state met the recommended number of BEmOC per 500,000 population but all the 12 states had adequate number of CEmOC (11).
In this study, facilities were classified as BEmOC minus 1 and CEmOC minus 1 and the major missing signal function for these facilities not meeting the UN process indicator standard was non- performance of assisted vaginal delivery, which at the primary health care level essentially means vacuum delivery.
This study also identified some facilities as BEmOC minus 2 which if upgraded can improve the geographical distribution of Emergency Obstetric Care Services.
Our result indicates that the expectation of the key stakeholders regarding the performance of the PHCs and health workers in MNH was somehow low in some areas, particularly the proportion of facilities expected to be providing all the components of BEmOC (which was just 50%) and the proportion of health workers expected to have satisfactory knowledge of MNH (60%).
Thus, compared to the results of previous studies (24,25), our finding indicates that availability of BEmOC facility remains a continued challenge for MNH services in Osun State.