BEmONC ServicesCEmONC Services
Antenatal Care
  • Registration (within first trimester)

  • Physical examination (weight, blood pressure, abdominal examination)

  • Ensuring consumption of iron-folic acid (IFA) tablets (100 IFA for all pregnant women or 200 IFA for pregnant women with anemia)

  • Essential lab investigations (Hb%, pregnancy test, urine for albumin/sugar) including blood grouping and pH typing, wet mount

  • Assured referral linkages for complicated pregnancies and deliveries

  • Management and provision of all emergency obstetric and newborn care for complications other than those requiring blood transfusion or surgery

  • Linkages with nearest Integrated Counseling and Testing Centre/Prevention of Parent-to-Child Transmission (ICTC/PPTCT) Centre for voluntary counselling and testing services

All BEmONC services plus:
  • Blood cross matching

  • Management of severe anemia

  • Management of complications in pregnancy referred from BEmONC

Intranatal Care
  • Normal delivery with use of partograph

  • Active management of third stage of labor

  • Identification and referral for danger signs

  • Pre-referral management for obstetric emergencies (eclampsia, postpartum hemorrhage, shock)

  • Assured referral linkages with higher facilities

  • Episiotomy and suturing cervical tear

  • Assisted vaginal deliveries (outlet forceps, vacuum)

  • Stabilization of patients with obstetric emergencies (eclampsia, postpartum hemorrhage, sepsis, shock)

All BEmONC services plus:
  • Round-the-clock maternal care services

  • Management of obstructed labor

  • Surgical interventions such as cesarean section

  • Comprehensive management of all obstetric emergencies (pregnancy-induced hypertension/eclampsia, sepsis, postpartum hemorrhage, retained placenta, shock)

  • In-house blood bank/blood storage center

  • Referral linkages with higher facilities including medical colleges

Newborn Services
  • Neonatal resuscitation

  • Warmth

  • Infection prevention

  • Initiation of breastfeeding within an hour of birth and exclusive breastfeeding thereafter

  • Screening for congenital anomalies

  • Weighing of newborns

  • Antenatal corticosteroids to the mother in case of preterm babies to prevent Respiratory Distress Syndrome (RDS)

  • Immediate care of low birth weight (LBW) newborns (>1800 g to <2500 g)

Newborn ServicesAll BEmONC services plus:
  • Round-the-clock newborn care services

  • Care of very LBW newborns (<1800 g)

Postnatal Care
  • Minimum 6 hours' stay post delivery

  • 48 hours' stay post delivery and all postnatal services for days 0 and 3 for mother and baby

  • Counseling for feeding, nutrition, family planning, hygiene, immunization, and postnatal check-up

  • Home visits on days 3, 7, and 42 for mother and baby

  • Additional visits for the newborn on days 14, 21, and 28

  • Additional visits may be necessary for LBW and sick newborns

  • Stabilization of mother with postnatal emergencies (postpartum hemorrhage, sepsis, shock, retained placenta)

  • Timely referral of women with postnatal complications

  • Referral linkages with higher facilities

  • Timely identification of danger signs and complications and referral of mother and baby

All BEmONC services plus:
  • Clinical management of all maternal emergencies such as postpartum hemorrhage, puerperal sepsis, eclampsia, breast abscess, postsurgical complication, shock, and any other postnatal complications such as RH incompatibility

Newborn Services
  • Warmth

  • Hygiene and cord care

  • Identification, management, and referral of sick neonates, LBW, and preterm newborns

  • Care of LBW newborns (<2500 g)

  • Zero day immunization–OPV (oral polio vaccine), BCG (bacille Calmette-Guerin for tuberculosis), Hepatitis B

  • Care of LBW newborns (>1800 g to <2500 g)

  • Referral services for newborns <1800 g and other newborn complications

  • Management of sepsis

Newborn ServicesAll BEmONC services plus:
  • Newborn care in district hospitals through Sick Newborn Care Unit (SNCU)

  • Management of complications

  • Care of very LBW newborns (<1800 g)

  • Establish referral linkages with higher facilities

  • Source: Reference 14