title: The state of routine and emergency obstetric and neonatal care in Southern Province, Zambia.
abstract: OBJECTIVE
  To evaluate the capacity of health facilities in Southern Province, Zambia, to perform routine obstetric care and emergency obstetric and neonatal care (EmONC).
  
  
  METHODS
  Surveys were completed at 90 health centers and 10 hospitals between September 1, 2011, and February 28, 2012. An expanded set of signal functions for routine care and EmONC was used to assess the facilities' capacity to provide obstetric and neonatal care.
  
  
  RESULTS
  Interviews were completed with 172 health workers. Comprehensive EmONC was available in only six of 10 hospitals; the remaining four hospitals did not perform all basic EmONC signal functions. None of the 90 health centers performed the basic set of EmONC signal functions. Performance of routine obstetric care functions, health worker EmONC training, and facility infrastructure and staffing varied.
  
  
  CONCLUSIONS
  Assessment of the indicators for routine care revealed that several low-cost interventions are currently underused in Southern Province. There is substantial room for improvement in emergency and routine obstetric and neonatal care at the surveyed facilities. Efforts should focus on improving infrastructure and supplies, EmONC training, and adherence to the UN guidelines for routine and emergency obstetric care.
authors.affiliation: Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD, USA. Electronic address: lowens15@jhmi.edu.
authors.forename: Lauren
authors.initials: L
authors.lastname: Owens
authors.affiliation: Center for Global Health and Development, Boston University, Boston, MA, USA; Department of International Health, School of Public Health, Boston University, Boston, MA, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Semrau
authors.affiliation: Ministry of Health, Lusaka, Zambia.
authors.forename: Reuben
authors.initials: R
authors.lastname: Mbewe
authors.affiliation: Ministry of Community Development, Mother and Child Health, Lusaka, Zambia.
authors.forename: Kebby
authors.initials: K
authors.lastname: Musokotwane
authors.affiliation: Center for Global Health and Development, Boston University, Boston, MA, USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Grogan
authors.affiliation: Center for Global Health and Development, Boston University, Boston, MA, USA; Department of International Health, School of Public Health, Boston University, Boston, MA, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Maine
authors.affiliation: Center for Global Health and Development, Boston University, Boston, MA, USA; Department of International Health, School of Public Health, Boston University, Boston, MA, USA; Section of Infectious Diseases, Department of Medicine, School of Medicine, Boston University, Boston, MA, USA; Zambia Center for Applied Health Research and Development, Lusaka, Zambia.
authors.forename: Davidson H
authors.initials: DH
authors.lastname: Hamer
mesh_terms: D002983:Clinical Competence; D036861:Delivery, Obstetric / Q000592:standards / Q000706:statistics & numerical data*; D003906:Developing Countries; D004632:Emergency Medical Services / Q000592:standards / Q000600:supply & distribution*; D004865:Equipment and Supplies, Hospital / Q000600:supply & distribution; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006761:Hospitals / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D010564:Personnel, Hospital / Q000600:supply & distribution; D011181:Postnatal Care / Q000592:standards / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000628:therapy*; D019984:Quality Indicators, Health Care; D015024:Zambia
keywords: Emergency obstetric and neonatal care (EmONC); Maternal health; Routine functions; Signal functions; Zambia