Quality Improvement for Emergency Obstetric Care
Leadership Manual and Toolbook
The purpose of this manual and accompanying toolbook is to assist health care providers working in emergency obstetric care (EmOC) settings to improve the quality of services within their facility. With whatever resources are at hand, quality improvement (QI) processes can help staff change and improve practices and conditions and, in so doing, have a significant impact on pregnancy outcomes. The manual describes a continuous, four-step QI process that is based on participatory principles of staff involvement and ownership and that focuses on clients' rights and needs. In the four ongoing steps, staff gather and analyze information, develop an action plan, implement solutions, and review and evaluate progress. Targeted toward supervisors or "team leaders" who will guide their staff through the process, the manual is designed for regular use by EmOC staff to assess and adjust systems and practices in a constructive way. The accompanying toolbook contains the information-gathering instruments used as part of the QI process, along with instructions for their use.
The revised manual and toolbook are updated versions of the 2001 working drafts Emergency Obstetric Care: Leadership Manual for Improving the Quality of Services and Emergency Obstetric Care: Toolbook for Improving the Quality of Services. Pilot-tested in several countries, these new versions are designed to be adaptable across cultures. The revised manual presents more information about the intended audience, some alternative methods for facilitating the QI process, and an enhanced definition of the "EmOC team." The revised toolbook presents simplified questions in the EmOC Assessment and expanded instructions for each tool.
The manual and toolbook are joint products of EngenderHealth and the Averting Maternal Death and Disability (AMDD) Program at the Mailman School of Public Health, Columbia University. Their development was supported by the AMDD Program and the Bill & Melinda Gates Foundation.
You can view or download the manual and toolbook in their entirety by clicking on the links below. Portions of the books can also be viewed or downloaded individually.
Quality Improvement for Emergency Obstetric Care: Leadership Manual
- Download the entire manual in English (PDF, 524 KB), in French (PDF, 550 KB), or in Spanish(PDF, 1 MB)
- Cover/Contents/List of Figures/List of Acronyms and Abbreviations/Acknowledgments (PDF, 185 KB)
- Chapter 1: Introduction (PDF, 163 KB)
- Chapter 2: Building a Vision: Laying the Foundation for Quality Improvement Processes at Your Site (PDF, 215 KB)
- Chapter 3: Facilitating the Quality Improvement Process (PDF, 288 KB)
- Chapter 4: Using Facilitative Leadership and Communication Skills (PDF, 176 KB)
- Chapter 5: Coordinating Medical Monitoring: The External Support Visit (PDF,175 KB)
- Appendix: Individual Performance and the Quality Improvement Process (PDF, 150 KB)
- References (PDF, 101 KB)
Quality Improvement for Emergency Obstetric Care: Toolbook
- Download the entire toolbook in English (PDF, 1 MB), in French (PDF, 441 KB), or in Spanish(PDF, 1 MB)
- Cover/Contents/List of Figures/List of Acronyms and Abbreviations/Acknowledgments (PDF, 153 KB)
- Chapter 1: Introduction: Emergency Obstetric Care Tools and the Quality Improvement Process(PDF, 140 KB)
- Chapter 2: EmOC Assessment (PDF, 318 KB)
- Chapter 3: EmOC Client/Family Interview (PDF, 112 KB)
- Chapter 4: EmOC Registers and Records Review (PDF, 160 KB)
- Chapter 5: Client Flow Analysis for EmOC (PDF, 198 KB)
- Chapter 6: Brief Case Review (PDF, 95 KB)