TABLE 1.

Attributes of Health Facility Readinessa in Routine Maternal Care

DomainDefinitionbAttribute
Human resourcesAdequacy of staff providing delivery care (positions designated are occupied)

  • 1. Adequate number of delivering personnel, per Ministry of Health staffing guidelines40

  • 2. At least 1 staff trained in basic emergency obstetric carec

InfrastructureBasic physical features and resources at the health facility that improve and maintain the health of the mother and infant

  • 3. Electricity available 24 hours/day and 7 days/week

  • 4. Improved water source within 500 m of facility

  • 5. Private room for patient consultation

  • 6. Access to clean and functioning toilets

  • 7. Communication equipment

  • 8. Safe disposal of sharps and infectious waste

Essential equipment and suppliesPresence of essential and lifesaving necessary items that may improve or maintain health of the mother and infant

  • 9. Newborn bag and mask

  • 10. Blood pressure cuff

  • 11. Adult stethoscope

  • 12. Fetal stethoscope

  • 13. Oxygen source

  • 14. Suction apparatus (mucus extractor)

  • 15. Sterilization equipment

  • 16. Vacuum aspirator or D&C kit

  • 17. Manual vacuum extractor for assisted vaginal delivery

  • 18. Adequate delivery instrument set

  • 19. Gloves

Essential drug stockSupply of essential and lifesaving medicines that may improve or maintain health of the mother and infant

  • 20. Injectable uterotonic

  • 21. Injectable antibiotics

  • 22. Injectable magnesium sulfate

  • 23. Intravenous solution

  • 24. 24. Antihypertensive medication

  • 25. Antibiotic eye ointment for newborns

ProcessesSeries of tasks or methods applied at the health facility that may improve or maintain health of the mother and infant

  • 26. Guidelines for IMPAC present in labor and delivery room

  • 27. Partograph forms and proof of use

Facility capacity and functionalityAbility for the health facility to occupy patient beds and accomplish functions and tasks that may improve or maintain health of the mother and infant

  • 28. Adequate number of delivery beds

  • 29. Availability of labor and delivery services 24 hours/day and 7 days/weekc

TransportationSupply of transportation that is functional and available to staff that may facilitate medical care at the health facility

  • 30. Motorized vehicle with motor fuel available for emergency referrals

  • Abbreviations: D&C, dilation and curettage; IMPAC, Integrated Management of Pregnancy and Childbirth.

  • ↵a 2015 World Health Organization’s Service Availability and Readiness Assessment Guidelines.34

  • ↵b To construct a facility readiness index, a score of 1 was assigned to each attribute for a maximum score of 30 attributes; a facility that met 28 or more attributes (corresponding to the highest decile of 30 attributes of the quality index) was considered to have adequate readiness of its routine maternity services.

  • ↵c Having at least 1 staff member who provided delivery care trained in emergency obstetric and neonatal care and availability of services 24 hours/day and 7 days/week were added in the index construct, as proposed by other researchers.35