Emergency obstetric and newborn care (EmONC) can be life-saving in managing well-known complications during childbirth. However, suboptimal availability, accessibility, quality and utilisation of EmONC services hampered meeting Millennium Development Goal target 5A. Evaluation and modelling tools of health system performance and future potential can help countries to optimise their strategies towards reaching Sustainable Development Goal (SDG) 3: ensure healthy lives and promote well-being for all at all ages. The standard set of indicators for monitoring EmONC has been found useful for assessing quality and utilisation but does not account for travel time required to physically access health services. The increased use of geographical information systems, availability of free geographical modelling tools such as AccessMod and the quality of geographical data provide opportunities to complement the existing EmONC indicators by adding geographically explicit measurements. This paper proposes three additional EmONC indicators to the standard set for monitoring EmONC; two consider physical accessibility and a third addresses referral time from basic to comprehensive EmONC services. We provide examples to illustrate how the AccessMod tool can be used to measure these indicators, analyse service utilisation and propose options for the scaling-up of EmONC services. The additional indicators and analysis methods can supplement traditional EmONC assessments by informing approaches to improve timely access to achieve Universal Health Coverage and reach SDG 3.
- emergency obstetric and newborn care
- physical accessibility
- universal health coverage
- sustainable development goals
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Handling editor Seye Abimbola
Contributors SE conceptualised the paper, designed the structure of the paper, and was the lead for research and writing of all sections. CMC, HLS, J-PM, KS, MB, NaR and NiR were involved in conceptualising the paper, provided research inputs and commented on the revisions. TTT was involved in conceptualising the paper. AHA, BO, CO, DS, EK, FMJ, HCC, HT, IBH, LO, MS, PG and OA provided research and writing inputs for the ‘Empirical applications of the indicators’ section. ACM, JFK and PEB were involved in revising the manuscript. All authors read and approved the final manuscript.
Funding Financial support was provided by the Government of Norway for the implementation of the projects in Burkina Faso, Cambodia, Laos and Malawi. GIS analysis of SMGL facilities/data in Nigeria was funded by Merck for Mothers.
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional unpublished data from the study are available.
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