A Tool for Assessing ‘Readiness’ in Emergency Obstetric Care: The Room-by-Room ‘Walk-Through’

This article presents a checklist tool that aims to improve organisation, management and oversight at facilities that deliver comprehensive or basic emergency obstetric care. The lead author is part of the Averting Maternal Death and Disability Program at Columbia University.The “readiness” of facilities to provide emergency obstetric care is crucial because maternal survival often depends on a rapid response. As such, the authors argue that well managed and organised health facilities are some of the most important factors in reducing maternal mortality. This includes human resources, equipment, drugs and supplies.The walk-though tool presented in the article is designed to reflect the route that a woman and her caregivers take through the facility, consistent with the six critical steps in emergency obstetric care:

1. Arrival
2. Evaluation and alert
3. Stabilisation or initial treatment
4. Definitive treatment
5. Monitoring and recovery
6. Information/counselling and discharge

The tool includes a list of inputs that must be available for emergency obstetric care at the facility gate, emergency evaluation area, labour/delivery room and laboratory/blood bank. To maximise its simplicity, the checklist asks only about the availability and functioning of the items and gives space for a short open-ended comment.The tool is designed to help inform and monitor improvements in management and organisation within the facility over time, by both facility staff and offsite individuals. It also aims to establish expectations among care providers and health system managers about the importance of readiness to provide emergency obstetric care.To read the article for free, click here.Gill, Z., Bailey, P., Waxman, R., & Smith, J.B. (2005). A tool for assessing ‘readiness’ in emergency obstetric care: The room-by-room ‘walk through’. International Journal of Gynecology and Obstetrics, 89, 191-199.