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Emergency Obstetric care
To Avert  Death and Disability… … We Need to Ensure that Women have Access To… Emergency Obstetric Care (EmOC)
How  Can We Improve Access  to EmOC? By making sure  health facilities provide the services needed to  save women’s lives. Eight key functions “signal” a facility’s ability to provide EmOC
EmOC Key Functions Cover These Services: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Basic and Comprehensive EmOC Facilities ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],BASIC EmOC Facilities Provide the First Six Services
Basic and Comprehensive EmOC Facilities ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],COMPREHENSIVE EmOC Facilities Provide All Eight Services ,[object Object],[object Object]
Continuum of Care ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
THE GOOD NEWS ,[object Object],[object Object],An Important Point  for Resource Poor Areas
How Can We Tell  We Are Making a Difference? ,[object Object],[object Object],WE CAN BE CONFIDENT  THAT WE ARE SAVING WOMEN’S LIVES
How Do We Know  Which Women  Will E xperience  Complications? WE DON’T
… But we do know that of any population of pregnant women at least 15% will experience an obstetric complication … This is as true of pregnant women in the US and Europe as of women in Africa, Asia and Latin America Nobody Knows Why This Happens. It is a Fact of Life.
Can We Really Tell if Services Are Functioning? ,[object Object],[object Object],These were issued by UNICEF/WHO/United Nation’s Population Fund (UNFPA) in 1997: Guidelines for Monitoring Availability  and Use of Obstetric Services … And Are Being Used?
[object Object],[object Object],[object Object],Process Indicators
[object Object],THE 6 PROCESS INDICATORS tell us about changes in: Utilization of… and Quality of… EmOC Services
EmOC Process Indicators ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
INDICATOR #1 For every 500,000 population, there should be at least: 1 Comprehensive EmOC Facility 4 Basic EmOC Facilities
INDICATOR #2 Geographical Distribution  of EmOC Facilities EmOC Facilities should be well-distributed to serve 500,000 people Minimum: 1 Comprehensive and 4 Basic EmOC Facilities
INDICATOR #3 Proportion of All Births  in EmOC Facilities At Least 15%  of All Births in the Community  Should Take Place in EmOC Facilities
INDICATOR #4 Met Need for EmOC Services At Least 100% of Women Estimated  to Have Obstetric Complications Should Be Treated in EmOC Facilities
INDICATOR #5 Cesarean Sections  as a Percentage of All Births Minimum:    5% Maximum: 15%
INDICATOR #6 Case Fatality Rate Proportion of Women  with Obstetric Complications  Admitted to a Facility  Who Die: Maximum Acceptable Level:  1%
CALCULATING ALL 6 INDICATORS ,[object Object],[object Object]
ACCESS TO EmOC ,[object Object],[object Object],[object Object],[object Object],[object Object]
UTILIZATION OF EmOC ,[object Object],[object Object],[object Object],Problems
UTILIZATION OF EmOC ,[object Object],[object Object],[object Object],[object Object],[object Object],If all the above is in place, conduct focus groups in the community to find out why women are not coming for care Action:  Collect More Information First
QUALITY OF EmOC Does Indicator # 6 show that more than 1% of women treated for obstetric complications are dying at your EmOC facilities? Problem:
QUALITY OF EmOC ,[object Object],[object Object],[object Object],Action: Get More Information
Any Country  Can Avert  Maternal Death and Disability if it Makes Good EmOC  Available and Accessible on Time
References ,[object Object],[object Object],[object Object],[object Object]

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01 Emergency Obstetric care

  • 2. To Avert Death and Disability… … We Need to Ensure that Women have Access To… Emergency Obstetric Care (EmOC)
  • 3. How Can We Improve Access to EmOC? By making sure health facilities provide the services needed to save women’s lives. Eight key functions “signal” a facility’s ability to provide EmOC
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10. How Do We Know Which Women Will E xperience Complications? WE DON’T
  • 11. … But we do know that of any population of pregnant women at least 15% will experience an obstetric complication … This is as true of pregnant women in the US and Europe as of women in Africa, Asia and Latin America Nobody Knows Why This Happens. It is a Fact of Life.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16. INDICATOR #1 For every 500,000 population, there should be at least: 1 Comprehensive EmOC Facility 4 Basic EmOC Facilities
  • 17. INDICATOR #2 Geographical Distribution of EmOC Facilities EmOC Facilities should be well-distributed to serve 500,000 people Minimum: 1 Comprehensive and 4 Basic EmOC Facilities
  • 18. INDICATOR #3 Proportion of All Births in EmOC Facilities At Least 15% of All Births in the Community Should Take Place in EmOC Facilities
  • 19. INDICATOR #4 Met Need for EmOC Services At Least 100% of Women Estimated to Have Obstetric Complications Should Be Treated in EmOC Facilities
  • 20. INDICATOR #5 Cesarean Sections as a Percentage of All Births Minimum: 5% Maximum: 15%
  • 21. INDICATOR #6 Case Fatality Rate Proportion of Women with Obstetric Complications Admitted to a Facility Who Die: Maximum Acceptable Level: 1%
  • 22.
  • 23.
  • 24.
  • 25.
  • 26. QUALITY OF EmOC Does Indicator # 6 show that more than 1% of women treated for obstetric complications are dying at your EmOC facilities? Problem:
  • 27.
  • 28. Any Country Can Avert Maternal Death and Disability if it Makes Good EmOC Available and Accessible on Time
  • 29.