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Objective: This paper examines the frequency with which a set of life-saving interventions or signal functions was performed to treat major obstetric complications.Methods and Results: The basic signal functions include parenteral antibiotics, anticonvulsants and oxytocics, and the procedures of manual removal of the placenta, removal of retained uterine products, and assisted vaginal delivery. Comprehensive functions include the six basic functions, cesarean delivery, and blood transfusions. Data from 1906 health facilities in 13 countries indicate that the most likely functions to be reported are oxytocics and antibiotics. The basic function least likely to be reported is assisted vaginal delivery. Many of the facilities surveyed did not have the infrastructure to perform operations or provide blood transfusions.Conclusions: These data can help governments allocate their budgets appropriately, help policy makers and planners identify systemic bottlenecks and prioritize solutions. Monitoring the performance of the functions informs us of the capacity of the health system to provide key interventions when obstetric emergencies occur. [ABSTRACT FROM AUTHOR]

Purpose: To improve the quality and accessibility of emergency obstetric care (EmOC) at district level.Methods: As the availability of safe and reliable blood transfusion services is a critical component of EmOC, financial and management support was provided to the blood transfusion service centers in the 3 project's Phase 1 districts.Evaluation: An evaluation after 3 years showed that, with modest financial outlays and the development of supportive district level partnerships, substantial improvements in quality and management of services had been achieved. The evaluation also identified limitations imposed by lack of legal frameworks and central support; although the Nepal Red Cross Society has a government mandate to supply the national blood needs, the operating procedures and guidelines have no legal base. The evaluation report was widely circulated, and the findings used in national policy discussions.Results: Following this a task force was commissioned to develop a legal policy framework to ensure standardized quality blood services with defined management and monitoring roles and responsibilities. [ABSTRACT FROM AUTHOR]