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Community Health Nursing
BEMONC & CEMONC with the skills to handle severe
Basic Emergency Obstetric and Newborn Care complications. (BEmONC) and Comprehensive 4. Increase Availability of Services: Make Emergency Obstetric and Newborn Care CEmONC available in regions with high maternal and neonatal mortality. (CEmONC) 5. Monitor Quality of Care: Ensure Introduction adherence to clinical guidelines and • BEmONC: Focuses on basic emergency standards. obstetric and newborn care, addressing common complications with seven key Key Components: signal functions. • CEmONC: Builds on BEmONC, adding BEmONC: • Seven essential signal functions: more advanced services, including surgical interventions and blood transfusions. 1. Parenteral Antibiotics: Treat • Both frameworks aim to improve maternal severe infections in mothers. and neonatal health outcomes, 2. Parenteral Uterotonics: Control particularly in low- and middle-income postpartum hemorrhage. countries. 3. Parenteral Anticonvulsants: Prevent seizures in eclampsia. Objectives: 4. Manual Removal of Placenta: Prevent bleeding from retained BEmONC: placenta. 1. Reduce Maternal and Neonatal 5. Removal of Retained Products Mortality: Provide timely and effective (Manual Vacuum Aspiration): emergency care for common childbirth Reduce infection and further complications. 2. Enhance Accessibility: Make emergency bleeding. obstetric care accessible, especially in 6. Assisted Vaginal Delivery: Use of rural and underserved areas. instruments to aid delivery in 3. Provide Essential Services: Deliver seven stalled labor. critical signal functions for obstetric 7. Neonatal Resuscitation: Revive emergencies. newborns not breathing at birth. 4. Strengthen Health Systems: Improve healthcare providers' capacity through CEmONC: • Includes all BEmONC functions plus: training, resources, and infrastructure. 1. Cesarean Section: Surgical 5. Promote Safe Deliveries: Encourage intervention for complicated facility-based deliveries to reduce deliveries. complications associated with home 2. Blood Transfusion: Address births. severe blood loss during childbirth. CEmONC: 1. Comprehensive Management of Comparison Complications: Offer more advanced services, including surgical procedures and blood transfusions. 2. Improve Referral Systems: Ensure timely transfer of patients needing advanced care. 3. Enhance Training for Healthcare Providers: Equip healthcare professionals Community Health Nursing Benefits and Importance: 1. Range of Interventions: • Reduction in Maternal Mortality: Timely o BEmONC: Basic interventions for interventions decrease maternal mortality common obstetric emergencies. rates. o CEmONC: Advanced procedures, • Improved Newborn Outcomes: Reduces including surgery and blood neonatal morbidity and mortality through transfusions. effective management. • Strengthening Health Systems: 2. Facility Requirements: Enhances overall capacity of health o BEmONC: Offered in rural health systems to respond to emergencies. centers or community clinics. • Cost-Effectiveness: BEmONC is more o CEmONC: Requires advanced cost-effective, addressing complications facilities like hospitals. at lower-level facilities. 3. Type of Care Provided: Challenges in Implementation: o BEmONC: Immediate, basic • Resource Limitations: Lack of emergency care. equipment, supplies, or trained personnel. o CEmONC: Comprehensive, life- • Geographic Barriers: Remote areas face saving treatment. challenges accessing facilities with BEmONC or CEmONC capabilities. 4. Personnel Needs: • Staffing Shortages: Insufficient skilled o BEmONC: Managed by trained healthcare providers, especially in rural midwives or general healthcare areas. providers. • Cultural Constraints: Cultural beliefs limit o CEmONC: Requires specialized access to emergency care and delay medical staff, including surgeons seeking help. and anesthesiologists. • Financial Barriers: Poverty prevents families from accessing emergency 5. Complexity of Cases: services. o BEmONC: Handles most obstetric • Awareness Gaps: Communities may be emergencies. unaware of BEmONC and CEmONC o CEmONC: Manages severe cases services, leading to underutilization. requiring advanced medical • Need for Policy Support and Funding: intervention. Continuous training, policy support, and funding are essential for sustainability. 6. Role in Healthcare System: o CEmONC: Acts as a backup to BEmONC, providing referral and Laws Supporting BEmONC and CEmONC: higher-level care. 1. Republic Act No. 10354 (2012) - Responsible Parenthood and 7. Accessibility: Reproductive Health Act o BEmONC: More accessible in rural o Purpose: Universal access to and low-resource areas. reproductive health care services, o CEmONC: Available in better- including maternal health. equipped, often urban or regional o Key Provisions: hospitals. ▪ Right to health care services, including emergency obstetric care. Community Health Nursing ▪Identifies BEmONC and ▪ Requires training for CEmONC as essential for BEmONC skills. reducing maternal and ▪ Sets standards for health neonatal mortality. facilities to provide 2. DOH Administrative Order No. 2008- BEmONC services. 0029 6. Republic Act No. 9710 - Magna Carta of o Overview: Health reforms to Women (2009) reduce maternal and neonatal o Purpose: Ensures women's rights mortality through the MNCHN and access to health services, Strategy. including maternal and newborn o Key Provisions: care. ▪ Establishes policies to o Key Provisions: address maternal and ▪ Requires appropriate neonatal death risks. emergency obstetric care ▪ Supports BEmONC and services within BEmONC CEmONC facility and CEmONC frameworks. development in local health ▪ Mandates government systems. support for maternal health 3. DOH Administrative Order No. 2009- programs. 0025 o Overview: Policies for essential newborn care in the first week of life. o Key Provisions: ▪ Reinforces BEmONC protocols. ▪ Ensures evidence-based newborn care to prevent neonatal deaths. 4. DOH Administrative Order No. 2010- 0014 o Overview: Allows midwives to administer life-saving drugs in emergencies. o Key Provisions: ▪ Specifies when midwives can provide emergency medications linked to BEmONC. ▪ Mandates training for safe administration of emergency drugs. 5. DOH Administrative Order No. 2015- 0020 o Overview: Strengthens capabilities of nurses and midwives in maternal and newborn care. o Key Provisions: Community Health Nursing PRACTICE QUIZ 6. Which law identifies BEmONC and CEmONC as essential components to reduce maternal 1. What is the primary focus of Basic and neonatal mortality? Emergency Obstetric and Newborn Care a) Republic Act No. 10354 (2012) - Responsible (BEmONC)? Parenthood and Reproductive Health Act a) Surgical interventions for severe complications b) DOH Administrative Order No. 2009-0025 b) Providing basic emergency care for common c) Republic Act No. 9710 - Magna Carta of obstetric complications Women (2009) c) Blood transfusions for severe blood loss d) DOH Administrative Order No. 2015-0020 d) Offering advanced neonatal care 7. Which of the following is a challenge in 2. What additional services does implementing BEmONC and CEmONC? Comprehensive Emergency Obstetric and a) Overabundance of trained healthcare Newborn Care (CEmONC) provide compared to professionals BEmONC? b) Geographic barriers and remote access to a) Parenteral antibiotics facilities b) Cesarean sections and blood transfusions c) Excessive financial resources available for c) Neonatal resuscitation maternal care d) Assisted vaginal deliveries d) High rates of awareness about emergency obstetric care 3. Which of the following is NOT one of the seven essential signal functions of BEmONC? 8. Which of the following laws allows midwives a) Cesarean section to administer life-saving drugs in emergencies? b) Neonatal resuscitation a) Republic Act No. 10354 (2012) c) Parenteral anticonvulsants b) DOH Administrative Order No. 2010-0014 d) Assisted vaginal delivery c) DOH Administrative Order No. 2008-0029 d) Republic Act No. 9710 - Magna Carta of 4. What is the main objective of CEmONC? Women (2009) a) Enhance accessibility to maternal care in rural areas 9. What is one key benefit of implementing b) Provide comprehensive management of BEmONC and CEmONC services? severe complications, including surgery a) Increased reliance on home births c) Promote home births with trained midwives b) Reduced maternal and neonatal mortality d) Reduce neonatal resuscitation needs c) Decreased need for healthcare provider training 5. What type of facility is required for providing d) Higher costs for emergency interventions CEmONC services? a) Rural health center 10. What is the key difference between b) Community clinic BEmONC and CEmONC in terms of personnel c) Hospital with advanced medical capabilities needs? d) Home-based care a) BEmONC requires highly trained surgeons and anesthesiologists b) CEmONC can be managed by trained midwives or general healthcare providers c) BEmONC can be managed by trained midwives or general healthcare providers, while CEmONC requires specialized medical staff d) CEmONC is managed by untrained volunteers Community Health Nursing ANSWER KEY 6. Which law identifies BEmONC and CEmONC as essential components to reduce maternal 1. What is the primary focus of Basic and neonatal mortality? Emergency Obstetric and Newborn Care a) Republic Act No. 10354 (2012) - Responsible (BEmONC)? Parenthood and Reproductive Health Act a) Surgical interventions for severe complications b) DOH Administrative Order No. 2009-0025 b) Providing basic emergency care for common c) Republic Act No. 9710 - Magna Carta of obstetric complications Women (2009) c) Blood transfusions for severe blood loss d) DOH Administrative Order No. 2015-0020 d) Offering advanced neonatal care 7. Which of the following is a challenge in 2. What additional services does implementing BEmONC and CEmONC? Comprehensive Emergency Obstetric and a) Overabundance of trained healthcare Newborn Care (CEmONC) provide compared to professionals BEmONC? b) Geographic barriers and remote access to a) Parenteral antibiotics facilities b) Cesarean sections and blood transfusions c) Excessive financial resources available for c) Neonatal resuscitation maternal care d) Assisted vaginal deliveries d) High rates of awareness about emergency obstetric care 3. Which of the following is NOT one of the seven essential signal functions of BEmONC? 8. Which of the following laws allows midwives a) Cesarean section to administer life-saving drugs in emergencies? b) Neonatal resuscitation a) Republic Act No. 10354 (2012) c) Parenteral anticonvulsants b) DOH Administrative Order No. 2010-0014 d) Assisted vaginal delivery c) DOH Administrative Order No. 2008-0029 d) Republic Act No. 9710 - Magna Carta of 4. What is the main objective of CEmONC? Women (2009) a) Enhance accessibility to maternal care in rural areas 9. What is one key benefit of implementing b) Provide comprehensive management of BEmONC and CEmONC services? severe complications, including surgery a) Increased reliance on home births c) Promote home births with trained midwives b) Reduced maternal and neonatal mortality d) Reduce neonatal resuscitation needs c) Decreased need for healthcare provider training 5. What type of facility is required for providing d) Higher costs for emergency interventions CEmONC services? a) Rural health center 10. What is the key difference between b) Community clinic BEmONC and CEmONC in terms of personnel c) Hospital with advanced medical capabilities needs? d) Home-based care a) BEmONC requires highly trained surgeons and anesthesiologists b) CEmONC can be managed by trained midwives or general healthcare providers c) BEmONC can be managed by trained midwives or general healthcare providers, while CEmONC requires specialized medical staff d) CEmONC is managed by untrained volunteers