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Monitoring and Policy Advocacy: The example of maternal mortality and the EmOC Process Indicators

Monitoring and Policy Advocacy: The example of maternal mortality and the EmOC Process Indicators. 8 February 2006 Monitoring for Health: A Dialogue on Current Practices and Perspectives OSI Network Public Health Program Istanbul, Turkey. Lynn Freedman. Hemorrhage (antepartum / postpartum)

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Monitoring and Policy Advocacy: The example of maternal mortality and the EmOC Process Indicators

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  1. Monitoring and Policy Advocacy:The example of maternal mortality and the EmOC Process Indicators 8 February 2006 Monitoring for Health: A Dialogue on Current Practices and Perspectives OSI Network Public Health Program Istanbul, Turkey Lynn Freedman

  2. Hemorrhage (antepartum / postpartum) Prolonged / Obstructed labor Postpartum sepsis Complications of abortion Pre-eclampsia / Eclampsia Ectopic pregnancy Ruptured uterus 7 Direct Obstetric Complications

  3. Basic EmOC Comprehensive EmOC EmOC Signal Functions 1) Administer parenteral antibiotics 1) Administer parenteral antibiotics 2) Administer parenteral oxytocic drugs 2) Administer parenteral oxytocic drugs 3) Administer parenteral anticonvulsants 3) Administer parenteral anticonvulsants 4) Perform manual removal of placenta 4) Perform manual removal of placenta 5) Perform removal of retained products 5) Perform removal of retained products 6) Perform assisted vaginal delivery 6) Perform assisted vaginal delivery 7) Perform surgery (cesarean section) 8) Perform blood transfusion

  4. UN EmOC Process Indicators

  5. UN EmOC Process Indicators • Answer these questions: • Are there enough facilities providing emergency obstetric services? If not, why? • Are they well distributed? • Are enough women using these life-saving services? • Are the right women using these facilities? • Are enough critical services being provided? • Is the quality of the services adequate?

  6. Uganda Needs Assessment: EMOC services available .

  7. Missing Functions at Health Centre IV Signal Function % Parental antibiotics 14 Parental oxytocics 11 Parental sedatives 64 Manual removal of placenta 47 Removal of retained products 50 Assisted vaginal delivery 89

  8. Connecting monitoring strategy to theories of change • Connect monitoring strategy to the epidemiology of the health problem • Focus on key policy barrier to change and power dynamic behind it • Mobilizes the currency (statistics) that has the most purchasing power among decisionmakers • In this field, what you count is what you do

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