New signal functions for routine and emergency newborn care

Project team: Sabine Gabrysch, Giulia Civitelli

External collaborators: Oona Campbell, Karen Edmond, Matthews Mathai, Moazzam Ali, Zulfiqar Bhutta

Funding: Rahel Goitein-Straus fellowship and Margarete von Wrangell fellowship for Sabine Gabrysch

Signal functions are a representative shortlist of key interventions and activities that address major causes of morbidity or mortality and that are indicative of a certain type and level of care. For instance, signal functions indicative of "basic emergency obstetric care (EmOC)" could be provided by midwives at the level of a health centre, while "comprehensive EmOC" signal functions indicate a higher level of care, usually at a hospital.

Signal functions for EmOC already exist and are widely used, however no signal functions for emergency newborn care (EmNC) have been defined (except resuscitation). Neither are there agreed signal functions for routine care at health facilities for either mother or newborn (i.e.care for all women and babies, as opposed to emergency care for complications). Current large-scale facility survey efforts mainly collect data on the established EmOC functions, and two EmNC functions (newborn resuscitation and prevention of mother-to-child transmission of HIV). Routine maternal or newborn care data are not regularly included.

We performed a literature review, mainly done by Giulia Civitelli during her internsip, and did an expert opinion survey to develop a set of 23 maternal and newborn signal functions, focussing on delivery and postnatal care. These can be used to characterize both routine and emergency care in health facilities in low-income settings. Collecting the relevant data and promoting its use in a variety of ways should contribute to monitoring and improving the quality of maternal and newborn care, helping to meet MDGs 4 and 5.

Publications:

Gabrysch S, Civitelli G, Edmond KM, Mathai M, Ali M, Bhutta ZA, Campbell OMR. (2012): New signal functions to measure the ability of health facilities to provide routine and emergency newborn care. PLoS Medicine, 9(11): e1001340. doi:10.1371/journal.pmed.1001340.