Table 3. Emergency childbirth care capability by facility level.
| Signal Function | Criteria (performance or presence of observed tracer items) | Facility performance by level of facility (%) | |||||||
|---|---|---|---|---|---|---|---|---|---|
| National/Provincial Hospital | District Hospital | Sub-district Hospital | “Other” Hospital | Health Center | Maternity | Clinic or Dispensary | Total Performance | ||
| Basic EmOC# | |||||||||
| Parenteral antibiotics | Performed in past 3 months (+ Injectable ampicillin/amoxicillin or gentamicin) | 100 (50) | 88 (48) | 76 (38) | 84 (44) | 51 (19) | 67 (51) | 31(11) | 52 (24) |
| Parenteral oxytocin | Performed in past 3 months (+ Injectable oxytocin) | 100 (100) | 92 (80) | 90 (61) | 96 (84) | 81 (65) | 85 (78) | 75 (54) | 82 (65) |
| Parenteral anticonvulsants | Performed in past 3 months (+ Injectable diazepam or magnesium sulphate) | 100 (87) | 64 (63) | 22 (20) | 57 (50) | 14 (11) | 24 (22) | 5 (5) | 20 (18) |
| Manual removal of placenta | Performed in past 3 months | 90 | 72 | 52 | 55 | 38 | 33 | 12 | 33 |
| Removal of retained products | Facility is “able to perform function” (+ Functioning vacuum aspirator or D&C kit) | 100 (100) | 89 (71) | 88 (58) | 93 (81) | 55 (40) | 72 (59) | 30 (15) | 55 (40) |
| Assisted vaginal delivery | Performed in past 3 months (+ Functioning ventouse vacuum extractor) | 59 (51) | 6 (6) | 3 (3) | 21 (20) | 0 (0) | 2 (2) | 0 (0) | 3 (3) |
| Comprehensive EmOC | |||||||||
| Blood transfusion | Performed in past 3 months | 100 | 58 | 8 | 49 | 4 | 23 | 0 | 13 |
| Caesarean section | Performed in past 3 months | 88 | 52 | 7 | 69 | 1 | 31 | 0 | 14 |
| Basic EmNC | |||||||||
| Antibiotics to mother if premature preterm rupture of membranes (PPROM) | Injectable ampicillin/amoxicillin or benzylpenicillin | 60 | 63 | 54 | 44 | 46 | 80 | 42 | 48 |
| Corticosteroids in preterm labor | Injectable dexamethasone in the pharmacy | 54 | 31 | 14 | 84 | 13 | 55 | 5 | 21 |
| Resuscitation with bag and mask | Facility has performed function in past 3 months (+bag or tube + mask for baby) | 100 (90) | 85 (81) | 64 (59) | 66 (60) | 44 (39) | 57 (46) | 18 (11) | 42 (35) |
| Kangaroo Mother Care (KMC) for premature or small babies | Practice is routine for all babies## | 94 | 62 | 49 | 48 | 57 | 49 | 41 | 50 |
| Injectable antibiotics | Injectable ampicillin/amoxicillin or gentamicin | 50 | 55 | 52 | 50 | 25 | 40 | 73 | 44 |
| Comprehensive EmNC | |||||||||
| Intravenous fluids | Intravenous infusion set & IV solutions (NS) in childbirth service area | 100 | 91 | 85 | 96 | 90 | 88 | 81 | 87 |
The percentage of facilities of a given type that performed a given function in the previous three months is represented by the first number; the percentage of facilities that performed the function in the previous three months AND had the tracer items necessary to perform the function at the time of survey are represented by the nested percentage in parentheses. We term this the percentage of facilities capable of performing a function.
# All tracer items in this category must be present in the room where deliveries take place or in an adjacent room
## The Kenya SPA did not specifically measure KMC, but did measure “as soon as possible after birth the baby is put in skin contact with the mother” and was asked for all babies, not specific to preterm/very small babies.