Basic Emergency Obstetric and
Newborn Care (BEmONC)
and
Comprehensive Emergency Obstetrics
and Newborn Care (CEmONC)
BEmONC
Basic Emergency Obstetrics and Newborn Care (BEmONC) Provider is a
capable
private health facility or an appropriately upgraded public health facility that
is either a
Rural Health Unit (RHU) and/or its satellite Barangay Health Station (BHS) or
Hospital
capable of performing the following emergency obstetric functions: (1)
parenteral
administration of oxytocin in the third stage of labor; (2) parenteral
administration of
loading dose of anti-convulsants; (3) parenteral administration of initial dose
of
antibiotics; (4) performance of assisted deliveries in imminent breech; (5)
removal of
retained placental products ; and (6) manual removal of retained placenta. It
is also
capable of providing neonatal emergency interventions, which include at the
minimum,
newborn resuscitation, provision of warmth, and referral. The hospital
CEmONC
Comprehensive Emergency Obstetrics and Newborn Care (CEmONC)
Provider is a
tertiary level regional hospital or medical center, provincial hospital or an
appropriately upgraded district hospital. It can also be a capable privately
operated medical center. It is capable of performing emergency obstetric
functions as in BEmONC provider facilities, as well as provides surgical
delivery (caesarean section) and blood bank transfusion services, and
other highly specialized obstetric interventions. It is also able to provide
emergency neonatal care, which include the minimum: (1) newborn
resuscitation; (2) treatment of neonatal sepsis/infection; (3) oxygen
support; and, (4) antenatal administration of (maternal) steroids for
threatened premature delivery. It can also serve as high volume providers
for intra-uterine device (IUD) and voluntary surgical contraception (VSC)
services.
Definition of Basic Emergency Obstetric and Newborn Care 
Health facilities that can perform the following six
signal obstetric functions: 
 Parental Administration of oxytocin in the third stage
of labor
 Parenteral administration loading dose of anti-convulsants
 Parenteral administration of initial dose of antibiotics 
 Performance of assisted deliveries (Imminent Breech delivery)
 Removal of retained products of conception 
 Manual removal of retained placenta.
Definition of Basic Emergency Obstetric and Newborn Care
These facilities are also able to provide emergency
newborn interventions, which include the minimum:
 Newborn Resuscitation
 Treatment of neonatal sepsis/infection
 Oxygen support
 It shall also capable of providing blood transfusion
services on top of its standard functions (Optional
for BEmONC Hospitals).
The following are the six (6) basic functions of a
BEmOC facility:
1. administer parenteral antibiotics ( initial loading
dose)
2. administer parenteral oxytocic drugs (for active
management of the 3rd stage of labor only)
3. administer parenteral anticonvulsants for
preeclampsia and eclampsia (initial loading dose)
4. perform manual removal of placenta
5. perform removal of retained products
6. perform assisted vaginal delivery
Goal, Coverage and Scope
The Safe Motherhood Policy embraces the
goal of
ensuring safe motherhood and healthy
newborns,
hence, its main objective is to reduce
maternal and
perinatal morbidity and mortality. Under this
policy, all women of reproductive age (15-49)
and
newborns up to 28 days of life are target of
interventions and services. Special attention
shall be
given to indigenous women, women among
highly
marginalized groups (fisher folks, farmers,
urban
OVERVIE
W
The Basic Emergency Obstetric and Newborn Care (BEmONC) in Crisis Settings,
Select Signal Functions outreach refresher training is designed for clinical trainers
conducting brief training on the key components of BEmONC. The target audience
for this training is health care workers who are currently attending or will attend
births in the acute phase of an emergency response. This includes midwives,
nurses, general practice physicians, obstetricians/gynecologists, and others.
The content is based on the most recent clinical evidence by the World Health
Organization (WHO) and IAWG’s 2018 Inter-Agency Field Manual for Reproductive
Health in Humanitarian Settings. It covers the necessary skills and professional
behaviors for handling common obstetric emergencies at multiple levels of care,
including:
 postpartum infection
 pre-eclampsia/eclampsia
 postpartum hemorrhage
EmONC Signal
Functions
BEmONC
 Administer parenteral antibiotics
 Administer uterotonic drugs
 Administer parenteral anticonvulsants
 Perform manual removal of the placenta
 Remove retained products of conception
 Perform assisted vaginal delivery
 Perform basic neonatal resuscitation
Comprehensive EmONC (CEmONC): All seven BEmONC Signal Functions plus
 Perform Caesarean delivery
 Provide blood transfusion
BEmONC
Signal Function 1: Administer Parenteral
Antibiotics
Signal Function 2: Administer Uterotonic
Drugs
 Puerperal sepsis accounts for 8% of
global maternal deaths and 33% of
maternal deaths in Kenya.*
 Effectively managed with injectable
antibiotics
 IV Pencillin G 2MU every 6 hours
 Plus Gentamicin 5 mg/kg body weight IV
every 24 hours
 Plus Metronidazole 500mg IV every 8
hours
 Postpartum hemorrhage accounts for
15% of global maternal deaths. Up to
33% of maternal deaths in Kenya*
 Effectively managed through active
management of third stage of labor
(AMTSL)
 IM oxytocin within 1 minute of delivery
*World Health Organization’s multicountry
Survey on Maternal and Newborn Health
Analysis of Maternal Mortality and
Mortality Kenya Statistical Report
*World Health Organization’s multicountry
Survey on Maternal and Newborn Health
Analysis of Maternal Mortality and
Mortality Kenya Statistical Report
BEmONC
Signal Function 3: Administer Parenteral
Anticonvulsants
Signal Function 4: Manually Remove
Placenta
 Severe pre-eclampsia and eclampsia
account for 10% of global annual
maternal deaths.
 Hypertensive disorders account for 35%
of maternal deaths in Kenya.*
 Effectively managed through use of
parenteral anticonvulsants
 Parenteral magnesium sulphate
 Retained placenta: A major cause of
postpartum hemorrhage and puerperal
sepsis – both leading causes of
maternal mortality
 Managed through manual removal of
the placenta; requires elbow-length
sterile gloves
*World Health Organization’s multicountry Survey on Maternal and Newborn
Health Analysis of Maternal Mortality and
Mortality Kenya Statistical Report
BEmONC
Signal Function 5: Remove Retained
Products of Conception
Signal Function 6: Perform Assisted
Vaginal Delivery
 Complications from abortion account for
15% of global annual maternal deaths.
 Managed effectively through manual
vacuum aspiration or medical
evacuation using misoprostol
 Postabortion care provides an
opportunity to prevent further
unplanned pregnancy by promoting
contraceptive use.
 Obstructed labour accounts for 6% of
maternal deaths.
 Assisted vaginal delivery, using forceps
or vacuum extraction, when done
appropriately, can avert unnecessary
hospital referral and caesarian delivery.
BEmONC
Signal Function 7: Perform Basic Neonatal
Resuscitation
 Perinatal asphyxia is a leading cause of
child mortality, accounting for 11% of
global under-five deaths annually.*
 Severe forms are associated with
serious long-term complications.
 Effective newborn resuscitation can
reduce morbidity and mortality
associated with perinatal asphyxia.
*Liu, L., et al. (2014). Global, regional, and
national causes of child mortality in 2000–
13, with projections to inform post-2015
priorities: An updated systematic
analysis.
The Lancet, 385 (996)
CEmONC
Signal Function 8: Perform Caesarean
Delivery
Signal Function 9: Provide Blood
Transfusion
 Caesarean section is a life-saving
procedure required when vaginal
delivery places the life or health of the
mother or baby at risk.
 It is the first of two additional signal
functions required in facilities
designated to provide CEmONC.
 Blood transfusion is a life-saving
procedure for women suffering from
postpartum hemorrhage – the leading
single cause of maternal mortality.
 Facilities providing CEmONC are
required to provide blood transfusion.
Summary
Maternal and newborn mortality are major
global and local public health challenges.
EmONC is a package of interventions
targeting the leading causes of maternal
and newborn mortality.
The Government of Kenya and partners
seek to ensure universal access to
EmONC.
Thanks for
listening