Signal functions are a representative shortlist of key interventions and activities that address major causes of morbidity or mortality and that are indicative of a certain type and level of care. For instance, signal functions indicative of “basic emergency obstetric care (EmOC)” could be provided by midwives at the level of a health centre, while “comprehensive EmOC” signal functions indicate a higher level of care, usually at a hospital.
Signal functions for EmOC already exist and are widely used, however no signal functions for emergency newborn care (EmNC) have been defined (except resuscitation). Neither are there agreed signal functions for routine care at health facilities for either mother or newborn (i.e.care for all women and babies, as opposed to emergency care for complications).
Current large-scale facility survey efforts mainly collect data on the established EmOC functions, and two EmNC functions (newborn resuscitation and prevention of mother-to-child transmission of HIV). Routine maternal or newborn care data are not regularly included.
This article contributes a proposed set of 23 maternal and newborn signal functions, focussing on delivery and postnatal care, that could be used to characterize both routine and emergency care in health facilities in low-income settings. The selection was based on literature review and expert opinion. Many thanks to all of you who answered our online survey posted here in March!
Collecting the relevant data and promoting its use in a variety of ways should contribute to monitoring and improving the quality of maternal and newborn care, helping to meet MDGs 4 and 5. In a few years time, when sufficient experience has been gained in different settings, it may be appropriate to revisit both EmOC and EmNC and routine functions and provide more authoritative guidance and benchmarks.