What is needed for taking emergency obstetric and neonatal programmes to scale?

Area of Science:

• Public Health
• Health Systems Strengthening

Background:

• Scaling up emergency obstetric and neonatal care (EmONC) programmes is crucial for expanding healthcare access.
• Implementation requires careful consideration of multiple simultaneous strategies across broader geographical areas.

Purpose of the Study:

• To provide a framework for understanding the implementation, scale-up, and sustainability of EmONC programmes.
• To explore the non-linear change process and necessary conditions for scaling up EmONC initiatives.

Main Methods:

• Literature review on EmONC scale-up strategies.
• Drawing on practical experience from scaling up the Essential Steps in the Management of Obstetric Emergencies (ESMOE) programme in South Africa.

Main Results:

• Identified equity, quality, and leadership as cross-cutting concepts essential for programme success.
• Outlined critical conditions for scale-up, including broad awareness and a supportive policy environment.

Conclusions:

• Successful EmONC programme scale-up hinges on a supportive policy environment, resource allocation, training, and effective monitoring.
• Addressing factors like commitment, health system strengthening, and dissemination is vital for sustainable expansion.