SERVICE DELIVERY

1
SERVICE DELIVERY

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

2
This Session

• Preparation
• Overview
• Services

3
Our Goal
To Improve the

• Availability
• Quality
• Utilization
• of
• Emergency Obstetric Care (EmOC)

4
The Crucial Fact

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

5
Therefore...

• All pregnant women
• need access to
• emergency obstetric care

6
The 3 Delays

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

7
Implementation of EmOC
2 Stages

• 1. Preparatory stage
• 2. Service delivery

8
Stage 1 Preparation

• Preparation Facility Staff

9
Stage 1 Preparation (cont...)

• Renovation and maintenance
• Supplies and equipment-procurement
• Facility setup

Facility
10
Stage 1 Preparation (cont.)

• Placement of staff
• Complete staff
• Transfers/posting
• Training
• Team building

Staff
11
Stage 1 Preparation (cont.)
Implementers Should

• Synchronize preparatory activities
• Move from preparatory to service delivery
  stage
• Keep focus on service delivery

12
Stage 2 Service Delivery

• Functioning
• Quality
• Utilization

13
Stage 2 Service Delivery (cont.)

• On-going readiness-facility and staff
• 24/7 EmOC

Functioning
14
Stage 2 Service Delivery (cont.)
Improving Quality

• Onsite, ongoing process
• External supervision

15
Stage 2 Service Delivery (cont.)

• Is it improving?

Utilization
16
Key Points of Implementation

• Balance and synchronize preparatory activities
• Move from preparatory to service delivery
  stage
• Focus on EmOC service delivery