Bergh Anne-Marie, Allanson Emma, Pattinson Robert C
Maternal and Infant Health Care Strategies Research Unit, Medical Research Council of South Africa and Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
School of Women's and Infants' Health, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia and Medical Research Council South Africa, Maternal and Infant Health Care Strategies Unit, Pretoria, South Africa.
Best Pract Res Clin Obstet Gynaecol. 2015 Nov;29(8):1017-27. doi: 10.1016/j.bpobgyn.2015.03.015. Epub 2015 Apr 1.
Scaling up an emergency obstetric and neonatal care (EmONC) programme entails reaching a larger number of people in a potentially broader geographical area. Multiple strategies requiring simultaneous attention should be deployed. This paper provides a framework for understanding the implementation, scale-up and sustainability of such programmes. We reviewed the existing literature and drew on our experience in scaling up the Essential Steps in the Management of Obstetric Emergencies (ESMOE) programme in South Africa. We explore the non-linear change process and conditions to be met for taking an existing EmONC programme to scale. Important concepts cutting across all components of a programme are equity, quality and leadership. Conditions to be met include appropriate awareness across the board and a policy environment that leads to the following: commitment, health systems-strengthening actions, allocation of resources (human, financial and capital/material), dissemination and training, supportive supervision and monitoring and evaluation.
扩大紧急产科和新生儿护理（EmONC）项目需要在可能更广阔的地理区域覆盖更多人群。需要同时关注多种策略并加以部署。本文提供了一个框架，用于理解此类项目的实施、扩大规模和可持续性。我们回顾了现有文献，并借鉴了我们在南非扩大产科紧急情况管理基本步骤（ESMOE）项目方面的经验。我们探讨了将现有的EmONC项目扩大规模所需的非线性变革过程和条件。贯穿项目所有组成部分的重要概念包括公平、质量和领导力。需要满足的条件包括全面的适当认知以及能带来以下结果的政策环境：承诺、卫生系统强化行动、资源（人力、财力和资本/物资）分配、传播与培训、支持性监督以及监测与评估。
