Facilities need to be equipped to prevent and manage the most common obstetrical and newborn complications.[i] According to the USAID Maternal Health Strategy, to achieve the greatest public health impact where maternal mortality is very high, the priority focus should be on BEmONC rather than CEmONC, with a plan to phase in CEmONC as the situation allows. The MOH should assess the capacity of its facilities to provide EmONC. This means that essential facilities, equipment, drugs, and supplies are available; protocols are established; providers are adequately trained and supervised; and a quality improvement system is in place with regular measurement and monitoring of key indicators.
Most deliveries at facilities are not emergencies, and providers should be able to support the normal birth process and monitor all deliveries using a partograph, which is a graphical record of progress during labor to identify deviations from normal and to prevent prolonged labor, infection, birth asphyxia, and obstetric fistula. Providers also should be trained to provide supportive and respectful care to a woman and her family during labor and delivery.
[i] Every Mother, Every Child: UN Commission on Life-Saving Commodities, 2014. https://www.mchip.net/sites/default/files/PPH%20Prevention%20at%20Home%20Birth%20Briefer.pdf