Essential basic and emergency obstetric and newborn care: From education and training to service delivery and quality of care

Abstract

Approximately 15% of expected births worldwide will result in life-threatening complications during pregnancy, delivery, or the postpartum period. Providers skilled in emergency obstetric and newborn care (EmONC) services are essential, particularly in countries with a high burden of maternal and newborn mortality. Jhpiego and its consortia partners have implemented three global programs to build provider capacity to provide comprehensive EmONC services to women and newborns in these resource-poor settings. Providers have been educated to deliver high-impact maternal and newborn health interventions, such as prevention and treatment of postpartum hemorrhage and pre-eclampsia/eclampsia and management of birth asphyxia, within the broader context of quality health services. This article describes Jhpiego's programming efforts within the framework of the basic and expanded signal functions that serve as indicators of high-quality basic and emergency care services. Lessons learned include the importance of health facility strengthening, competency-based provider education, global leadership, and strong government ownership and coordination as essential precursors to scale-up of high impact evidence-based maternal and newborn interventions in low-resource settings.

Effect of support supervision on maternal and newborn health services and practices in Rural Eastern Uganda

“…Life-threatening complications during pregnancy, delivery and the postpartum period are commonly encountered disproportionately in low- and middle-income countries [1,2]. The health complications of pregnant women, mothers and newborns cannot be mitigated without due attention to the quality of care [3,4].…”

“…Skilled delivery has long been indicated as the most effective intervention; but with the prevalent shortage of life-saving products and equipment, health workers cannot be expected to literally save lives with their bare hands [5]. The availability of Emergency Obstetric Care (EmOC) services is a major strategy to ensure that pregnant women and newborns have access to well-functioning facilities that include a wide range of maternal and newborn services [1,2,6,7]. The basic EmOC services that should always be at the facilities include administration of parenteral antibiotics, perinatal antibiotics, oxytocic drugs and anticonvulsants, manual removal of placenta, removal of retained products and assisted vaginal delivery [1].…”

“…The availability of Emergency Obstetric Care (EmOC) services is a major strategy to ensure that pregnant women and newborns have access to well-functioning facilities that include a wide range of maternal and newborn services [1,2,6,7]. The basic EmOC services that should always be at the facilities include administration of parenteral antibiotics, perinatal antibiotics, oxytocic drugs and anticonvulsants, manual removal of placenta, removal of retained products and assisted vaginal delivery [1]. Facilities that provide comprehensive services should perform all basic EmOC services, as well as cesarean section and provision of blood transfusion [2,7].…”

“…The availability of EmOC services, availability of skilled health workers and their knowledge in the provision of maternal and newborn care services are therefore essential components for improved maternal and newborn care services. In addition, the EmOC package should include infection prevention and management, monitoring and management of labor using partographs, active management of third stage of labor, infant thermal protection, feeding and HIV prevention [1]. …”

Validação de conteúdo de instrumento de avaliação do recém-nascido

“…(1,2) In recognition of the relevance of the issue of maternal and neonatal mortality to the present day, the United Nations has proposed as one of the goals of the Sustainable Development Goals to eliminate preventable deaths of newborns and children under five, aiming to reduce neonatal mortality to 12 per 1,000 live births by 2030 (UN, 2015). (3) The child in the first week of life is more vulnerable to problems related to biological, socioeconomic and health care determinants, this being a period considered as adaptive in the extra-uterine environment, which makes maternal and child follow-up indispensable for health promotion.…”