Bemonc Checklist

Strengthening Maternal and Child
Health Services in Eastern Visayas
Centre for Health Development - Eastern Visayas

Family Health Cluster
Basic Emergency Obstetric and Newborn Care (BEmONC)
Supportive Supervision at RHU/DHC - Check list 1: Resources
Facility:
Date:
Areas
1. Human
resources
What to observe
Yes
No
Remarks
1 There is a complete BEmONC team?
How many remain of BEmONC trainees

Number trained (
2 Midwives trained: Are they all still in service
How many remain of trained midwives?

3 An ambulance driver available for 24 hours
4 The person assigned for cleaning is on duty today?
2. Facility
and
Hygiene
Check for each room for cleanliness and privacy

1
Rooms and equipment are clean, including lavatory and the

area under the cushion of delivery table.
2 There are means to protect client's privacy
There is an evidence that the staff are practicing handwashing always (water, soap, clean towels, paper towel etc)
4 The facility has adequate water-supply
3
5 All instruments are autoclaved or sterilized? (no soaking)
6
7
8
3.
Readiness
for
receiving
cases/ for
emergency
9
1
If not using autoclave or sterilizer, how is it done?

Ask what is the recommended process of sterilization.
(Decontamination, wash, dry, wrap individually and sterilize
for adequate duration) Do they follow it?
Sharps are disposed as per guideline?
There is a placental pit for the disposal of the placenta
A wall thermometer is available in the Delivery Room.
BEmONC Manual is readily available
2 There are sterilized delivery packs ready for use (at least 2)
Oxytocin and emergency medicines are available. (MgSO4,

Calcium Gluconate, hydralazine, ergometrine)
4 Syringes and needles (in various sizes) are available
3
5 IV fluids and tubing, cannula are ready for use

6
7
8
9
10
11
4. Logistics
and
Supplies
Drugs and supplies are organized in such a way that it is

easy to locate them
Oxygen is ready for use
Room is ready for newborn resuscitation (ambubag,
designated place, means for keeping the baby warm)
There is a functioning ambulance/ means of transport
There are means to communicate (telephone, radio) with
referral hospitals and health offices
Telephone directory of emergency contacts is clearly placed
and everyone knows it. ( hotline number, the number of
MHO/DHO and referral hospitals, ambulance driver)
Equipment required for the BEmONC services are available
and functional (see the list and RHU/DHC's inventory)?
There are adequate drugs and supplies (see the list and
RHU/DHC's inventory)
Recording forms are available. (blank ones for ANC, Labor,
3
Partograph, PNC, Newborn Care, Referral)
2
5. Service
24 hours delivery services is in place including weekend
delivery and 1 (There is a roster of midwives)
performanc
How many deliveries took place last month?Check with
e
2
delivery logbook)
3 There is a functioning delivery tracking system
If not functioning, ask why?
4 How many deliveries are expected this month?
Labor Rm
Yes No
Delivery Rm
No
Yes
Postnatal Rm
No
Yes
Areas
6. MNDR
What to observe
Yes
Remarks
No
1 There is updated Maternal and Neonatal/infant death

2 logbook
Number of maternal deaths this year since January
(in the area covered by the facility)
3 How many of above were reviewed?
4 Number of newborn deaths this year since January

6 Number of newborn deaths this year since January

7. LGU/
Community
support
1 Blood donors list is available
LGU passed following resolution/ordinance.

2 1) Facility based deliveries
3 2) User-fees
4 3) Incentives for CHT
If passed, are they implemented?

5 1) Facility based deliveries
6 2) User-fees
7 3) Incentives for CHT
8,
PhilHealth
1 This facility is currently accredited for MCP

2 This facility is currently accredited for Newborn screening
3
The facility receives the reimbursement regularly from

PhilHealth
4 if so, when was the last reimbursement received?
When:
Assessment: (Count the number of 'yes' answers and put in the corresponding box)
V.Poor
Area
1
1.1
1.2
Human resources adequate and trained
Poor
Good
V.Good
0-1
How many remain of those BEmONC trained (Number trained:

)
How many remain of trained midwives (Number trained:
)
Facility in good condition, organized and clean
0-3
4-7
8-11
12-13
Readiness for receiving cases/ for emergency
0-2
3-6
7-9
10-11
LGU's commitment for drugs/supplies and equipment
maintenance
Delivery service provided and functionality of tracking system
6.1
MDR being conducted (% of reviewed/deaths)
6.2
NDR being conducted (% reviewed/deaths )
7
8
Availability and implementation of Resolutions/Ordinances on

FBD, user's fees and incentives for CHT
Philhealth accreditation for MCP/Newborn screening (MCP+)
and regular reimbursement
0-1
0-2
3-4
5-6
Things to improve List those items which had 'No' answer

Note: If the BEmONC team is not complete, it should be reported to PHO via SSV report
Supervisor:

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Strengthening Maternal and Child

Health Services in Eastern Visayas

Centre for Health Development - Eastern Visayas

1 There is a complete BEmONC team?

How many remain of BEmONC trainees

2 Midwives trained: Are they all still in service

How many remain of trained midwives?

Check for each room for cleanliness and privacy

Rooms and equipment are clean, including lavatory and the

2 There are means to protect client's privacy

5 All instruments are autoclaved or sterilized? (no soaking)

If not using autoclave or sterilizer, how is it done?

Oxytocin and emergency medicines are available. (MgSO4,

5 IV fluids and tubing, cannula are ready for use

Drugs and supplies are organized in such a way that it is

1 There is updated Maternal and Neonatal/infant death

(in the area covered by the facility)

3 How many of above were reviewed?

(in the area covered by the facility)

4 Number of newborn deaths this year since January

(in the area covered by the facility)

6 Number of newborn deaths this year since January

7 How many of above were reviewed?

1 Blood donors list is available

LGU passed following resolution/ordinance.

If passed, are they implemented?

1 This facility is currently accredited for MCP

The facility receives the reimbursement regularly from

4 if so, when was the last reimbursement received?

Human resources adequate and trained

How many remain of those BEmONC trained (Number trained:

Readiness for receiving cases/ for emergency

LGU's commitment for drugs/supplies and equipment

MDR being conducted (% of reviewed/deaths)

NDR being conducted (% reviewed/deaths )

Availability and implementation of Resolutions/Ordinances on

Things to improve List those items which had 'No' answer

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