Comprehensive Emergency Obstetric and New born Care (CEmONC) Services

Introduction

Analysis of the maternal and infant mortality data revealed that 75% of maternal deaths occured during intra partum and post partum and 25% occured in antepartum. One common issue was that of referral. When the hospital where the pregnant woman accessed for care did not have adequate facilities, she had to be referred to another hospital elsewhere. Covering the distance between two hospitals at such a critical stage could prove fatal, as it was usually the complicated cases that were referred to other hospitals especially in the rural areas. Hence, it was decided to strengthen the obstetric and new born services in the hospitals which led to the creation of the ‘Comprehensive Emergency Obstetric and Neonatal Care’ Centres.

Establishment of CEmONC Centres

In September 2004, a Government Order was passed to establish CEmONC Centres in the State. During Phase 1, 66 Centres were established (52 project hospitals and 14 tertiary care centres) such that the travel time was reduced to approximately an hour. In Phase 2, 32 Centres were established and in Phase 3, 27 centres were established.

Salient Features of CEmONC Centres

The CEmONC Centre is equipped with both the manpower and the infrastructure required to care for the mother and the new born. Round the clock, the centre has Obstetricians, Paediatricians, Doctors, Staff Nurses, lab technicians, and support staff on duty and Anesthetists on call.

Intensive inputs were provided, in terms of training and physical infrastructure, to ensure quality care.

Around 508 doctors and 562 nurses positions have been sanctioned and posted exclusively for CEmONC services in addition to the existing doctors and nurses.

The centre is equipped with a fully functional maternity block, including a labour ward, operation theatre, blood bank/storage unit, new born ward, new born intensive care unit (NICU) and isolation ward. Buildings worth Rs. 150 crores and equipment worth Rs. 40 crores have been provided to the CEmONC Centres.

Services Available in a CEmONC Centre

• Resuscitation of all obstetric emergencies
• Resuscitation of all newborn emergencies
• Blood transfusion facilities with all groups of blood
• Supportive lab and imaging services
• PPTCT Services
• Free antenatal and postnatal counseling services
• Free 108 emergency ambulance system maintained
• Uninterrupted power supply
• Healthcare waste management facility

Services in the Labour Room

• Emergencies met by trained obstetrician and staff nurse round the clock
• Emergency treatment protocols, equipment and drugs are available in the casualty, labour room and new born care services
• Emergency USG are taken for maternal emergencies
• Partographs are used
• Bio medical waste management procedures followed

Services for Care of the Newborn

• Resuscitation of new born by trained paediatrician
• Emergency treatment protocols, equipment and drugs are available in the casualty, labour room and new born care services
• Initiation of breast feeding immediately after birth