title: Basic and comprehensive emergency obstetric and neonatal care in 12 South African health districts.
abstract: OBJECTIVE
  To assess the functionality of healthcare facilities with respect to providing the signal functions of basic and comprehensive emergency obstetric care in 12 districts.
  
  
  METHODS
  Twelve districts were selected from the 52 districts in South Africa, based on the number of maternal deaths, the institutional maternal mortality ratio and the stillbirth rate for the district.
  
  
  METHODS
  All community health centres (CHCs) and district, regional and tertiary hospitals were visited and detailed information was obtained on the ability of the facility to perform the basic (BEmONC) and comprehensive (CEmONC) emergency obstetric and neonatal care signal functions.
  
  
  RESULTS
  Fifty-three CHCs, 63 district hospitals (DHs), 13 regional hospitals and 4 tertiary hospitals were assessed. None of the CHCs could perform all seven BEmONC signal functions; the majority could not give parenteral antibiotics (68%), perform manual removal of the placenta (58%), do an assisted delivery (98%) or perform manual vacuum aspiration of the uterus in a woman with an uncomplicated incomplete miscarriage (96%). Seventeen per cent of CHCs could not bag-and-mask ventilate a neonate. Less than half (48%) of the DHs could perform all nine CEmONC signal functions (81% could perform eight of the nine functions), 24% could not perform caesarean sections, and 30% could not perform assisted deliveries.
  
  
  CONCLUSIONS
  The ability of the CHCs and district hospitals to perform the signal functions (lifesaving services) of basic and comprehensive emergency obstetric care was poor in many of the districts studied. This implies that safe maternity care was not consistently available at many facilities conducting births.
authors: R C
authors: RC
authors: Pattinson
authors: J D
authors: JD
authors: Makin
authors: Y
authors: Y
authors: Pillay
authors: N
authors: N
authors: Van den Broek
authors: J
authors: J
authors: Moodley
mesh_terms: D003151:Community Health Centers / Q000458:organization & administration*; D004630:Emergencies / Q000453:epidemiology*; D004632:Emergency Medical Services / Q000592:standards*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000458:organization & administration*; D006767:Hospitals, District; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008427:Maternal Health Services / Q000458:organization & administration*; D008428:Maternal Mortality / Q000639:trends; D011247:Pregnancy; D011787:Quality of Health Care; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology