SERVICE DELIVERY Zafarullah Gill Jason Smith Averting Maternal Death and Disability Program Columbia University

Zafarullah Gill

Jason Smith

Averting Maternal Death and Disability Program

Columbia University

This Session: Preparation Overview Services

Preparation

Overview

Services

Our Goal • Availability • Quality • Utilization of Emergency Obstetric Care (EmOC) To Improve the:

• Availability

• Quality

• Utilization

of

Emergency Obstetric Care (EmOC)

The Crucial Fact Once a woman is pregnant most serious obstetric complications cannot be predicted or prevented, but they CAN be treated.

Once a woman is pregnant

most serious obstetric complications

cannot be predicted or prevented,

but they CAN be treated.

Therefore... All pregnant women need access to emergency obstetric care

All pregnant women

need access to

emergency obstetric care

The 3 Delays 1. Deciding to seek treatment 2. Reaching an EmOC facility 3. Receiving treatment

1. Deciding to seek treatment

2. Reaching an EmOC facility

3. Receiving treatment

Implementation of EmOC 1. Preparatory stage 2. Service delivery 2 Stages:

1. Preparatory stage

2. Service delivery

Stage 1: Preparation Preparation = Facility + Staff

Preparation = Facility + Staff

Stage 1: Preparation (cont...) • Renovation and maintenance • Supplies and equipment-procurement • Facility setup Facility:

• Renovation and maintenance

• Supplies and equipment-procurement

• Facility setup

Stage 1: Preparation (cont.) • Placement of staff Complete staff Transfers/posting • Training • Team building Staff:

• Placement of staff

Complete staff

Transfers/posting

• Training

• Team building

Stage 1: Preparation (cont.) • Synchronize preparatory activities • Move from preparatory to service delivery stage • Keep focus on service delivery Implementers Should:

• Synchronize preparatory activities

• Move from preparatory to service delivery stage

• Keep focus on service delivery

Stage 2: Service Delivery • Functioning • Quality • Utilization

• Functioning

• Quality

• Utilization

Stage 2: Service Delivery (cont.) • On-going readiness-facility and staff • 24/7 EmOC Functioning:

• On-going readiness-facility and staff

• 24/7 EmOC

Stage 2: Service Delivery (cont.) • Onsite, ongoing process • External supervision Improving Quality:

• Onsite, ongoing process

• External supervision

Stage 2: Service Delivery (cont.) Is it improving? Utilization:

Is it improving?

• Balance and synchronize preparatory activities • Move from preparatory to service delivery stage • Focus on EmOC service delivery Key Points of Implementation

• Balance and synchronize preparatory activities

• Move from preparatory to service delivery stage

• Focus on EmOC service delivery