The availability of life-saving obstetric services in developing countries: an in-depth look at the signal functions for emergency obstetric care

Int J Gynaecol Obstet. 2006 Jun;93(3):285-91. doi: 10.1016/j.ijgo.2006.01.028. Epub 2006 Mar 6.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Anticonvulsants / administration & dosage
  • Anticonvulsants / therapeutic use
  • Developing Countries / statistics & numerical data*
  • Emergency Medical Services / standards*
  • Emergency Medical Services / statistics & numerical data
  • Emergency Treatment / statistics & numerical data*
  • Equipment and Supplies, Hospital / statistics & numerical data
  • Equipment and Supplies, Hospital / supply & distribution
  • Female
  • Humans
  • Infusions, Parenteral / statistics & numerical data
  • Maternal Mortality*
  • Obstetrics / standards*
  • Obstetrics / trends
  • Oxytocics / administration & dosage
  • Oxytocics / therapeutic use
  • Pregnancy


  • Anti-Bacterial Agents
  • Anticonvulsants
  • Oxytocics