Skilled birth attendant strategies Go to maternity waiting home ahead of labour 0 1 Routine 2 transport pathways 3 Facility with routine care Facility with routine (or alongside care & midwifery unit) & 1 4 Facility with routine Home Maternity care only CEmOC Waiting BEmOC Home Emergency 4 3 2 transport pathways Campbell OMR, Calvert C, Testa A, Strehlow M, Benova L, Keyes E, Donnay F, Macleod D, Gabrysch S, Rong L, Ronsmans C, Sadruddin S, Koblinsky M & Bailey P. The scale, scope, coverage & capability of childbirth care. Lancet 2016
Challenges • Women reluctant to access services/particular facilities due to fear of contracting Covid-19 • Public and private transport severely limited • Ambulance services overwhelmed & not prioritized for access to PPE • Not all facilities providing their usual services - women and families uncertain where to go and providers not always certain where to refer women • Problems not picked up in ANC/develop during home delivery – meaning women arrive in facilities very sick
National/Local Responses • Policies on allowing pregnant women and newborns to travel during lockdowns • Increased use of telephone/telemedicine/ digital platforms • Efforts to produce up to date information on what services are being provided where (for women, families and health workers)/ whats app • Mobilising community responses (CHW/Private sector) • Provision of PPE • Careful attention to screening and separating patients & utilization of schools and other facilities services – flow of patients • Sending midwives to women’s homes
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