The effect of implementation strength of basic emergency obstetric and newborn care (BEmONC) on facility deliveries and the met need for BEmONC at the primary health care level in Ethiopia
Basic emergency obstetric and newborn care (BEmONC) is a primary health care level initiative promoted in low and middle-income countries to reduce maternal and newborn mortality. Tailored support, including BEmONC training to providers, mentoring and monitoring through supportive supervision, provision of equipment and supplies, strengthening referral linkages, and improving infection-prevention practice, was provided in a package of interventions to rural districts of Ethiopia to ensure timely BEmONC care. In recent years, there has been a growing interest in measuring program implementation strength to evaluate public health gains. To assess the effectiveness of the BEmONC initiative, this study measures its implementation strength and examines the effect of its variability across intervention health centers on the rate of facility deliveries and the met need for BEmONC. Before and after data was collected from a two year period from 2013-2015. A BEmONC implementation strength index was constructed from seven input and five process indicators measured through observation, record review, and provider interview; while facility delivery rate and the met need for expected obstetric complications were measured from service statistics and patient records. From 2013 to 2015 the BEmONC implementation strength index score increased statistically significantly, as well as the corresponding health center delivery rate.
Authors: Gizachew Tiruneh, Ali Karim, Bilal Avan, Nebreed Zemichael, Tewabech Wereta, Deepthi Wickremasinghe, Zinar Keweti, Zewditu Kebede, Wuleta Betemariam