{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T07:03:39Z","timestamp":1793603019400,"version":"4.5.0"},"reference-count":34,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T00:00:00Z","timestamp":1644969600000},"content-version":"unspecified","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"World Bank's Trust Fund supported by Australia's Department of Foreign Affairs and Trade","award":["WB contract: 7171956, PI: M. Khan, July 1 2014"],"award-info":[{"award-number":["WB contract: 7171956, PI: M. Khan, July 1 2014"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,1,26]]},"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To measure the readiness of health facilities in Papua New Guinea (PNG) to provide obstetric care and other maternal health services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study involving random sample of health centres, district\/rural hospitals (levels 3 and 4 facilities) and all upper-level hospitals operational at the time of survey. Structured questionnaires were used to collect data from health facilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Health facilities in PNG. Facility administrators and other facility personnel were interviewed. Number of facility personnel interviewed was usually one for health centres and two or more for hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>19 upper-level facilities (levels 5\u20137, provincial, regional and national hospitals) and 60 lower-level facilities (levels 3 and 4, health centres and district\/rural hospitals).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Four service-types were used to understand readiness of surveyed health facilities in the provision of maternity care including obstetric care services: (1) facility readiness to provide clinical services; (2) availability of family planning items; (3) availability of maternal and neonatal equipment and materials; and (4) ability to provide emergency obstetric care (EmOC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>56% of lower-level facilities were not able to provide basic emergency obstetric care (BEmOC). Even among higher-level facilities, 16% were not able to perform one or more of the functions required to be considered a BEmOC provider. 11% of level 3 and 4 health facilities were able to provide comprehensive emergency obstetric care (CEmOC) as compared with 83% of higher-level facilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Given the high fertility rate and maternal mortality ratio (MMR) in PNG, lack of BEmOC at the first level inpatient service providers is a major concern. To improve access to EmOC, level 3 and 4 facilities should be upgraded to at least BEmOC providers. Significant reduction in MMR will require improved access to CEmOC and optimal geographic location approach can identify facilities to be upgraded.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-050150","type":"journal-article","created":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T11:46:22Z","timestamp":1645098382000},"page":"e050150","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Readiness of health facilities to provide emergency obstetric care in Papua New Guinea: evidence from a cross-sectional survey"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8219-996X","authenticated-orcid":false,"given":"Xiaohui","family":"Hou","sequence":"first","affiliation":[{"name":"Health, Nutrition and Population Global Practice, World Bank Group, Washington, District of Columbia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0301-5657","authenticated-orcid":false,"given":"M Mahmud","family":"Khan","sequence":"additional","affiliation":[{"name":"Health Policy and Management, University of Georgia College of Public Health, Athens, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Pulford","sequence":"additional","affiliation":[{"name":"International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK"},{"name":"Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga P M","family":"Saweri","sequence":"additional","affiliation":[{"name":"Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,2,17]]},"reference":[{"key":"2025120518311584000_12.2.e050150.1","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.ijgo.2005.06.029","article-title":"Improvement of coverage and utilization of EmOC services in southwestern Bangladesh","volume":"91","author":"Islam","year":"2005","journal-title":"Int J Gynaecol Obstet"},{"key":"2025120518311584000_12.2.e050150.2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-13-136"},{"key":"2025120518311584000_12.2.e050150.3","doi-asserted-by":"crossref","DOI":"10.7189\/jogh.07.020802","article-title":"Readiness of hospitals to provide kangaroo mother care (KMC) and documentation of KMC service delivery: analysis of Malawi 2014 emergency obstetric and newborn care (EmONC) survey data","volume":"7","author":"Chavula","year":"2017","journal-title":"J Glob Health"},{"key":"2025120518311584000_12.2.e050150.4","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1093\/heapol\/czz028","article-title":"The effectiveness of training in emergency obstetric care: a systematic literature review","volume":"34","author":"Ameh","year":"2019","journal-title":"Health Policy Plan"},{"key":"2025120518311584000_12.2.e050150.5","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-11-S3-S10","article-title":"Care during labor and birth for the prevention of intrapartum-related neonatal deaths: a systematic review and Delphi estimation of mortality effect","volume":"11 Suppl 3","author":"Lee","year":"2011","journal-title":"BMC Public Health"},{"key":"2025120518311584000_12.2.e050150.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2006.01.030"},{"key":"2025120518311584000_12.2.e050150.7","doi-asserted-by":"crossref","DOI":"10.3402\/gha.v9.31880","article-title":"Assessing emergency obstetric care provision in low- and middle-income countries: a systematic review of the application of global guidelines","volume":"9","author":"Banke-Thomas","year":"2016","journal-title":"Glob Health Action"},{"key":"2025120518311584000_12.2.e050150.8","unstructured":"Government of Papua New Guinea . 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