bottleneck analysis bemoc and cemoc group -2 nepal, bangladesh, pakistan, afghanistan, sri lanka,...
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Bottleneck AnalysisBEmOC and CEmOC
Group -2Nepal, Bangladesh, Pakistan,
Afghanistan , Sri Lanka, Indonesia
BEmONC
Priority BottlenecksSupply side
• Policy and Strategic Plan and Poor Governance
• Inappropriate allocation of Fund
• Insufficient HR/ Skilled Person/Distribution /Retention/Accredit
Possible Solutions
• Policy Document need to be updated and scaled up
• Proper allocation of fund and planning for MNCH services
• Ensure 24/7 , task shifting• Production of SBA ( Mid wives)
/strengthening• Performance based
Incentive /enabling environment to address those issues
BEmONC
Bottle Neck– Monitoring and Supervision
– MIS
– No structural or Poor Referral Mechanism
Possible Solution• Strengthening of E-
monitoring and supervision• Strengthening of MIS with
analysis and action• Strengthening Accountability of
all service providers• Referral Guidelines must be
implemented and provision of Vehicle /PPP (Referral HUB)
• Coordination between service delivery levels (mobile phone, Maternity waiting home etc)
BEmONC
Bottle NeckDemand side:• Lack of knowledge and
decision power to use the BEmONC facilities.
• Lack of Accessibility , acceptability and affordability of BEmONC facilities
• In Equity – Geographical
(Urban rural, poor-rich)– Economic – Cultural
Possible Solution
Women empowerment through education /BCC through communication (C4D)
• Equitable availability of quality B & CmONC of care in the facility/PPP
• Equity focused , evidence based LLP
• Equitable resources allocation
CEmONC
Additional BottleneckSupply Side• Infrastructure
– Diagnostic – OT (Operation Theater)– HR– Maintenance– Blood Transfusion
Possible Solutions
• Need based planning • Ensure trained manpower in
place • Readiness of the facility
according to the checklist• Ensure diagnostic and blood
transfusion facility• Demand side Financing and
PPP
Unique Problem
Bottleneck• Pakistan
– Natural Disaster – Geographical and sociocultural and
Female Education
• Nepal– Cultural – Geographical
• Afghanistan– Financial Allocation– Security – Geographical
• Indonesia– Decentralization No policy to support sustainability of BEmOC and CEmOC
Possible Solutions• Readiness for Emergency
preparedness and response plan for Mother and Child
• Culture appropriate need based plan
• Establish policy for the functioning all public and private hospital to provide EmOC
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