Professional Documents
Culture Documents
CEmONC SERVICES
Comprehensive Emergency Obstetric and New born
Care services (CEmONC)
Analysis of the maternal and infant mortality data revealed that 75% of
maternal deaths occured during intra partum and post partum and 25% occured in
antepartum.
One common issue was that of referral. When the hospital where the pregnant
woman accessed for care did not have adequate facilities, she had to be referred to
another hospital elsewhere. Covering the distance between two hospitals at such a
critical stage could prove fatal, as it was usually the complicated cases that were
Hence, it was decided to strengthen the obstetric and new born services in the
hospitals which led to the creation of the ‘Comprehensive Emergency Obstetric and
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Establishment of CEmONC Centres
and 14 tertiary care centres) such that the travel time was reduced to
approximately an hour.
were established.
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Salient features of CEmONC Centre
The CEmONC Centre is equipped with both the manpower and the
infrastructure required to care for the mother and the new born.
Staff Nurses, lab technicians, and support staff on duty and Anesthetists on
call.
Around 508 doctors and 562 nurses positions have been sanctioned
and posted exclusively for CEmONC services in addition to the existing doctors
and nurses.
a labour ward, operation theatre, blood bank/storage unit, new born ward, new
born intensive care unit (NICU) and isolation ward. Buildings worth Rs. 150
crores and equipment worth Rs. 40 crores have been provided to the CEmONC
Centres.
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Services available in a CEmONC Centre
* Resuscitation of all obstetric emergencies * Free antenatal and postnatal counseling services
* Resuscitation of all newborn emergencies * Free 108 emergency ambulance system maintained
* Blood transfusion facilities with all groups of blood * Uninterrupted power supply
* Supportive lab and imaging services * Healthcare waste management facility
* PPTCT Services
* Emergencies met by trained obstetrician and staff * Resuscitation of new born by trained paediatrician
nurse round the clock
* Emergency treatment protocols, equipment and
* Emergency treatment protocols, equipment and drugs are available in the casualty, labour room and
drugs are available in the casualty, labour room and new
new born care services born care services
*
* Emergency USG are taken for maternal emergencies Initiation of breast feeding immediately after birth
* Partographs are used
* Bio medical waste management procedures
followed
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Training
assistants were provided the following trainings to improve the technical skills in delivery
* All Staff nurses in CEmONC Centres were trained to use Partograph by OG specialists.
* All staff nurses were given 15-day hands-on training on emergency and labor ward
skills.
* Paediatricians were trained on setting up and maintaining the Neonatal Intensive Care
Unit (NICU).
* Obstetricians were given 15 days skills training in Medical Colleges on the management
of emergency obstetric care.
* Blood bank training through Tamil Nadu State AIDS Control Society (TANSACS) to the
technicians concerned.
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Counselling services
The counselors have been provided with booklets and counseling materials to
aid them in advising the mothers on a variety of subjects, including appropriate diet,
antenatal, and postnatal care, family planning services, and immunization of babies.
Management unit medical officer. Quarterly review is done by the Director of Medical
and Rural Health Services. State-level review is done by the Special Secretary, Health
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Certifying CEmONC Centres
CEmONC Centres are certified once in every 2 years to ensure that the services
An expert team visits the centre with a 36 page format prescribing norms for
labour ward, neonatal unit, operation theatre and blood bank. Deficiencies pointed out
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Quality of Care
infection control and waste management is also one of the priorities. Some of
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Reducing the travel time
The CEmONC’s have been placed in locations where people can access them, approximately in
30 minutes. This time has been further reduced by the 108 emergency ambulance services which ensure
that adequate tranport is available during critical times. So far, the 108 emergency ambulances have
No. of centres 66 32 27
During the period 2006 -2009, a total of 2,62,255 complicated maternal cases and 63,580
neonatal cases were treated through CEMONC Centres. This resulted in reduction of maternal
mortality rate from 19.5 to 13.7, and neonatal mortality rate from 5.24 to 3.73.
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Analysis of data
Studies on data from CEmONC Centres
There is ample data available at the CEmONC Centres to facilitate studies on maternal and child health.
* A study to analyze the indications for LSCS, maternal complications, and the outcome of
referral in and referral out of antenatal mothers in Tamil Nadu: Study completed. Data is being
consolidated and analysis to commence.
* Study on congenital anomalies: An on going study is being conducted to arrive at the reasons for
high congenital anomalies in five hospitals.
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