Purpose of consultancy:

Sri Lanka, has made tremendous progress in reducing maternal mortality and is considered a success story in Low-Middle Income-Country(LMIC) setting. However, there are challenges in ensuring Emergency Obstetric and Newborn Care (EmONC) services still. The equity of distribution of facilities and utilization remain areas that need further improvement. These services play a vital role in reducing preventable maternal mortality, morbidity, and newborn mortality and morbidity.

Conducting a comprehensive EmONC needs assessment in Sri Lanka is crucial to identify current strengths, weaknesses, gaps, and opportunities within the healthcare system. This assessment will provide valuable data to inform targeted interventions and resource allocation, ultimately leading to a more robust and equitable EmONC service delivery network (Mailman School of Public Health, 2024a).

By understanding the specific needs of pregnant women, newborns, and healthcare providers at various levels, we can tailor strategies to address critical areas. This could include further improving access to essential EmONC facilities, strengthening referral systems, enhancing the skills and training of healthcare personnel, and promoting community awareness about the importance of seeking timely EmONC care (Moran et al., 2016).

The Comprehensive EmONC Needs Assessment which was done in 2011 provided valuable information for many programme development (Family Health Bureau, 2012). The National Strategic Plans of Maternal and Newborn Health (2014-2017) and (2018-2025) and many other strategic plans in the country benefited from the assessment. As a result of the identification of gaps in service provision, many policy decisions were taken and implemented over the years.

After the initial EmONC needs assessment, 11 years have passed. The country went through a global pandemic, economic crisis and many policy changes in health. The impact of the economic crisis was multifaceted on the health system. The reduced investment on maternity care, health worker migration and reduction of the number of deliveries in the country has affected different aspects of the care. There is a need to conduct this survey to provide information on the adequacy of facilities, the skill mix of health workers, equity and the quality of services.

To this end, UNFPA will support the conduct of the Comprehensive EmONC needs assessments by the lead institution, the Family Health Bureau of the Ministry of Health, UNFPA is hiring an Obstetrician & Gynaecologist who will lead the EMONC assessment. The lead consultant will direct the work of a team of consultants (Public Health Specialist and Neonatologist) and a research company.