Table 4. Routine childbirth care capability by facility level.
| Signal function | Observed tracer items (corresponding protocols/drugs/equipment) | Facility performance by level of facility (%) | |||||||
|---|---|---|---|---|---|---|---|---|---|
| National/ Provincial Hospital | District Hospital | Sub-district Hospital | “Other” Hospital | Health Center | Maternity Home | Clinic or Dispensary | Total Performance | ||
| General Requirements | |||||||||
| Service availability 24/7 | 100 | 100 | 100 | 100 | 87 | 97 | 66 | 83 | |
| Infrastructure | |||||||||
| Communication tools | Radio or telephone | 100 | 96 | 94 | 97 | 88 | 96 | 93 | 92 |
| High quality referral system | Referral form (+ Ambulance) | n/a | 53 (40) | 56 (44) | 64 (43) | 45 (16) | 43 (24) | 15 (0) | 35 (15) |
| Electricity, any type | 100 | 99 | 94 | 100 | 92 | 96 | 63 | 83 | |
| Toilet or latrine | Functioning latrine for clients | 100 | 100 | 99 | 100 | 96 | 100 | 100 | 99 |
| Water supply | Piped or running water | 100 | 92 | 95 | 92 | 44 | 52 | 17 | 46 |
| Routine Childbirth Care (Maternal)# | |||||||||
| Monitoring and management of labor using partograph | Blank partograph + fetoscope (pinard or electric) | 100 | 85 | 84 | 79 | 72 | 61 | 39 | 61 |
| Infection prevention measures during childbirth (hand-washing, gloves) | Clean water source + hand soap + gloves (latex or non- latex) | 81 | 57 | 61 | 72 | 30 | 31 | 9 | 30 |
| Active management of 3rd stage of labor | |||||||||
| Routine injection of oxytocin within one minute of delivery | Practice is routine** (+ Injectable oxytocin/syntocin or ergometrine/methergine with valid date) | 84 (84) | 75 (64) | 60 (44) | 58 (52) | 65 (53) | 58 (51) | 38 (30) | 54 (45) |
| Controlled cord traction | Practice is routine** (+ Cord clamp/ties and scissors/blade) | 100 (100) | 92 (86) | 91 (82) | 95 (94) | 85 (79) | 75 (71) | 83 (66) | 86 (76) |
| Uterine massage after delivery of placenta | Practice is routine** | 100 | 92 | 88 | 87 | 86 | 88 | 70 | 81 |
| Routine Childbirth Care (Newborn)# | |||||||||
| Thermal protection | |||||||||
| Drying baby immediately after birth | Practice is routine** (+ Towel for baby) | 100 (86) | 98 (24) | 99 (29) | 100 (65) | 99 (25) | 98 (58) | 97 (20) | 98 (30) |
| Skin-to-skin with mother | Practice is routine** | 94 | 62 | 49 | 48 | 57 | 49 | 41 | 50 |
| Wrapping | Practice is routine** (+ Blanket for baby) | 100 (35) | 98 (11) | 99 (15) | 100 (54) | 99 (21) | 98 (54) | 97 (24) | 98 (27) |
| No bath in first 6 hours | Practice is routine** | 100 | 97 | 96 | 82 | 95 | 82 | 94 | 93 |
| Immediate and exclusive breastfeeding | Practice is routine** | 92 | 97 | 99 | 92 | 97 | 93 | 93 | 95 |
| Hygienic cord care (cutting with sterile blade) | Scissors/blade | 100 | 93 | 92 | 100 | 92 | 93 | 94 | 94 |
#All tracer items in this category must be observed in the room where deliveries take place or in an adjacent room.
** Practices were considered to be routine if the facility representative interviewed endorsed the practice as routine.
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 performed a 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.