Proxy indicator for the physical availability and geographical accessibility of emergency obstetric services and their distribution across districts in the affected areas. An unbalance between the availability of BEmOC and CEmOC (with too few BEmOC) is often observed.
Number of functional health facilities, i.e. all public and private health facilities, with Comprehensive Emergency Obstetric Care in a defined administrative or health area at a certain point in time
The total population for the same administrative or health area, at the same point in time
Administrative area; health area; public/private; support/no support from humanitarian organisations
Indicator used for response monitoring ?
Threshold / Standard
>= 1 health facilities with Comprehensive Emergency Obstetric Care/ 500,000 population; Follow-up of trends
Calculation: CEmOC includes BEmOC plus caesarian sesction plus safe blood transfusion available 24 hours and 7 days Interpretation: This indicator is a snapshot of the situation at a certain period of time. At the pre-crisis phase, this indicator will indicate the baseline availability of health services. In the early phase after a crisis occurs, this indicator will show the consequences of the crisis (decrease/reduction in availability of health services) when compared to pre-crisis and the needs in term of support to health facilities. At later stages of crisis, trends in this indicator will allow to monitor the response in supporting health services. Limitation: this indicator measures the availability of health services but does not measure access to the service by the popualtion nor the quality of service and is therefore only a proxy for coverage. Quality of services (including trained staff and adequate supplies) should be further appraised.
Guidance on phases
There is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc...
Guidance for pre-crisis/baseline
Census of health facilities and assessment of service availability should be available pre-crisis through the realisation of SARA or HeRAMS.
Numerator: census of health facilities; assessment of functionality of health facilities; assessment of service availability (eg SARA, HeRAMS); Denominator: administrative boundaries; health areas boundaries; population per administrative area; population per health area;
Further guidance: Monitoring Emergency Obstetric Care (http://www.who.int/reproductivehealth/publications/monitoring/9789241547734/en/)