Background: Emergency Obstetric Care (EOC) refers to a set of life-saving interventions used to treat direct obstetric cases. One way of reducing maternal mortality is improving the quality of EOC for the treatment of indicated cases through the Basic Emergency Obstetric Care (BEmOC) component. However, there was no evaluation conducted in the study area and the level of quality of BEmOC was not known. Hence, the objective of this evaluation was to assess the quality of BEmOC in the health centers of Jimma town, Ethiopia.

Methods: A case study design using both quantitative and qualitative methods was employed from March 11-April 14, 2020. The case was the BEmOC program. The focus of the evaluation was on the process and the approach of the evaluation was formative. Availability, compliance, and satisfaction dimensions were assessed using multiple indicators. Data were collected from 263 clients consecutively at the exit, and respective patient’s chart review, 4 facilities’ resource inventory, 10 key informants interviews, 28 observation sessions, and review of relevant documents using structured questionnaires, interview guide, and checklists. Descriptive statistics, simple and multiple linear regression analyses were done. Factors associated with client satisfaction were identified at 95%CI and a P-value of <0.05. The overall quality of service was determined based on pre-stated judgment criteria. Qualitative data were transcribed and translated to English, and then coded manually through thematic analysis.

Results: Availability, compliance and satisfaction dimensions of this evaluation scored 69.1%, 73.7% and 66.6% respectively. The overall quality of BEmOC services achieved a score of 70.39%. Although mainly required resources were available, there was a shortage of BEmOC trained staff, drugs (magnesium sulfate, Oxytocin), equipment (vacuum extractor and CBC machine), and supplies (glove and syringe) in all health centers. In the last three months prior to this evaluation, three signal functions were not performed at two health centers. Two of the BEmOC signal functions, administration of anti-hypertensive treatment and assisted delivery, were provided for 10 (30.3%) and 24(54.5%) clients respectively. These are less performed functions as compared to other services. This is due to the shortage of magnesium sulfate and the absence of recommended functional vacuum extractor. But the removal of retained products of conception was provided to all 8(100%) clients that were well performed. About 62.7% of the clients were satisfied with BEmOC services. Parity, waiting time, consultation time, number of ANC visits, and occurrence of complications were significant predictors of client satisfaction.

Conclusion: Availability, compliance, and satisfaction dimensions were judged as fair. The overall quality of BEmOC services was also judged as fair that needs program level improvement. Program resources should be consistently available and supplied in the facilities. Recruiting additional midwives, keep trained them, monitoring performance, and using partograph appropriately are needed. Service provision should be in line with WHO and national standards.