B subha sri mps course july 2010
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MEETING HEALTH SYSTEMS CHALLENGES RELATED TO EMERGENCY OBSTETRIC CARE PowerPoint PPT Presentation


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B Subha Sri, MPS Course, July 2010. MEETING HEALTH SYSTEMS CHALLENGES RELATED TO EMERGENCY OBSTETRIC CARE. Maternal death – Medical causes. Hemorrhage Hypertensive disorders Sepsis Obstructed labour Unsafe abortion

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MEETING HEALTH SYSTEMS CHALLENGES RELATED TO EMERGENCY OBSTETRIC CARE

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B subha sri mps course july 2010

B Subha Sri,

MPS Course, July 2010

MEETING HEALTH SYSTEMS CHALLENGES RELATED TOEMERGENCY OBSTETRIC CARE


Maternal death medical causes

Maternal death – Medical causes

  • Hemorrhage

  • Hypertensive disorders

  • Sepsis

  • Obstructed labour

  • Unsafe abortion

    Which woman will develop complications cannot be predicted in advance – High risk approach not enough.

    Skilled birth attendance with access to Emergency Obstetric Care for all women.


Types of emergency obstetric care

Types of Emergency Obstetric Care

Basic Emergency Obstetric Care

Comprehensive Emergency Obstetric Care

All (1 to 6) functions included in basic EmOC

plus:

7) Perform surgery (e.g., cesarean section)

8) Perform blood transfusion

  • 1) Administer parenteral antibiotics

  • 2) Administer parenteraloxytocic drugs

  • 3) Administer parenteral anticonvulsants for preeclampsia and eclampsia

  • 4) Perform manual removal of placenta

  • 5) Perform manual removal of retained products (e.g., manual vacuum aspiration)

  • 6) Perform assisted vaginal delivery


Characteristics of quality emoc

Characteristics of quality EMOC

  • Good quality EmOC involves a state of readiness which enables the team to respond to unforeseen emergencies efficiently and continually, while protecting rights of the client


Readiness

Readiness

  • Achieving and maintaining a state of preparedness for provision of quality EmOC

    • 24 X 7 service

    • Staff with requisite skills

    • Willingness

    • Available and functional equipment and supplies

    • Adequate infrastructure


Response

Response

  • Avoid third delay

  • Prompt care

  • Appropriate

  • Accepted technical quality


Rights related to highest attainable standards of health

Rights – related to highest attainable standards of health

  • Patient rights

    • Access to EmOC services and continuity of care

    • Safe (competent) EmOC

    • Information and informed choice

    • Privacy and confidentiality, dignity, comfort, and expression of opinion

  • Provider rights

    • respect, dignity, and freedom to express their opinion

    • Positive work environment

    • Maintenance of skills – Information and training

    • Supplies, equipment, infrastructure


Quality of emoc

Quality of EmOC

Quality improvement is an improvement in the level of performance of a key process

  • It involves

  • Measuring current performance

  • Finding out ways to improve performance

  • Implementation of newer and better methods


Principles of quality improvement

Principles of Quality Improvement

  • Staff involvement

  • Client mindset consideration

  • Focus on systems and processes rather than persons’ shortcomings

  • Cost consciousness and efficiency

  • Continuous learning, capacity building

  • Tapping internal resources


Steps in quality improvement

Steps in Quality Improvement

  • Gathering and analysing data

  • Developing action plan

  • Implementing solutions

  • Review of progress and suggestions


Critical steps in emoc

Critical steps in EmOC


Process indicators for emoc unicef who unfpa

PROCESS INDICATORS FOR EmOC(UNICEF, WHO, UNFPA)

  • 1) Number of EmOC facilities

    • For every 5,00,000 population

      • At least 4 Basic EmOC facilities

      • At least 1 Comprehensive EmOC facility

        2) Geographic distribution

    • Minimum level is met in subnational areas

      3) Percentage of births in EmOC facilities

    • At least 15% of all births in the population take place in EmOC facilities


Process indicators for emoc unicef who unfpa1

PROCESS INDICATORS FOR EmOC(UNICEF, WHO, UNFPA)

  • 4) Met need for EmOC

    • All women with obstetric complications are treated in EMOC facilities

      No. of women with obstetric complications treated in EmOC facilities

      _______________________________

      15% of estimated live births in catchment area

    • Based on assumption that 15% of live births are associated with a major obstetric complication


Process indicators for emoc unicef who unfpa2

PROCESS INDICATORS FOR EmOC(UNICEF, WHO, UNFPA)

  • 5) Caesarean section rate

    • Not less than 5% and not more than 15% of all births in the population are by caesarean section.

      6) Case fatality rate

    • Not more than 1% of women with obstetric complications admitted to comprehensive EmOC facilities die.


Quality in emoc can mean

Quality in EmOC can mean

  • Improving the Readiness, Response and Rights

  • Improving performance on the Process Indicators


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