Local Individual Consultant: EmONC Assessment towards Improving Emergency Obstetric and Newborn Care (EmONC)

Job Description Position: Local Individual Consultant for EmONC Assessment towards Improving Emergency Obstetric and Newborn Care (EmONC), Bhutan Background In 2018, the Ministry of Health conducted the first of its countrywide assessment of EmONC (Emergency Obstetric and Newborn Care) services using the AMDD (Averting Maternal death and disability) tool. The cross-sectional facility-based survey used 12 modules as data collection instruments from 3 referral hospitals, 21 hospitals and 23 Basic Health Units (BHU) I.

The assessment provided critical findings related to the health facility performances based on the critical clinical interventions (EmONC signal functions). Since then, there have been changes in the maternal and newborn landscape in Bhutan. Quality improvement, a human rights-based approach to respectful maternity care, health system strengthening and implementation science have come together to create new norms. Quality of care can no longer be seen as simply a side issue of improving technical delivery of clinical interventions in the facility, but also the experience of care.

Globally, there is focus on keeping the mother-newborn dyad together as much as possible during their stay in a facility, even in the event of obstetric or newborn complications. Therefore, there is a need to incorporate geographic modeling to map the travel time for EmONC accessibility into assessments of EmONC functionality, ensuring that a strategically selected network of referral maternal cares can be realistically reached within 1 and 2 hours of an emergency and be able to provide quality EmONC care. With the launch of third child incentive in Bhutan (2026), every pregnancy is counted and the risks associated with advanced age pregnancy are expected to become more frequent.

Monitoring the availability, readiness, and functionality of EmONC services remains a key priority for Ministries of Health and development partners. However, routinely collecting and using reliable EmONC data to guide decision-making remains a major challenge and comprehensive EmONC assessments are resource-intensive and infrequent, limiting their application to real-time program management. Therefore, to address these challenges, UNFPA introduced the EmONC Light Assessment Tool (LAT), a simplified approach designed to streamline data collection on essential EmONC readiness and service provision. This light assessment evaluates the availability, readiness, utilization, and quality of signal functions in selected health facilities to guide immediate policy and program decisions.

The Overall Purpose Of This Consultancy Is To Support The Ministry Of Health To Conduct An EmONC Light Assessment Using The EmONC Light Assessment Tool (LAT), a Simplified Approach Designed To Streamline Data Collection On Essential EmONC Readiness And Service Provision. The LAT Focuses On a Minimum Set Of Tracer Indicators That Assess The Presence Of Skilled Personnel, Key Drugs And Supplies, Functional Equipment, And The Performance Of Critical Signal Functions At Health Facility Level. It Enables Ministries Of Health And Partners To Systematically Assess And Track The Availability, Readiness, And Performance Of EmONC Services As Part Of Ongoing Efforts To Reduce Maternal And Newborn Morbidity And Mortality, Specifically Capturing Information On Key Inputs And Functions For Quality EmONC Service Delivery Including

• Availability of essential drugs, supplies, and equipment,
• Human resource capacity and presence of skilled providers,
• Functionality of signal functions for obstetric and newborn care,
• Service utilization and outcomes, including deliveries, complications, and referrals, and
• Readiness of the infrastructure and referral system supporting EmONC service delivery.

Scope of Work (Description of services, activities, or outputs): The overall EmONC Light Assessment programme in Bhutan will focus on:

• Service Availability: Measure the presence and geographic distribution of Basic EmONC (BEmONC) and Comprehensive EmONC (CEmONC) facilities [FM1]
• Signal Functions: Assess whether facilities perform vital signal functions over a retrospective 3-month period
• Readiness & Inputs: Verify tracer indicators including essential medicines, consumable medical supplies, functioning equipment, and skilled human resources
• Bottleneck Analysis: Combine facility data with travel-time mapping or GIS tools to locate cove…