Abstract
BACKGROUND: Global maternal mortality rates have declined significantly over the past two decades, including an 80% reduction in Laos since 2000. Effective management of obstetric complications - a major contributor to maternal deaths - requires well-staffed facilities equipped with essential supplies, medicines, and infrastructure. Despite progress, Laos still faces gaps in service availability and readiness limiting further reductions in preventable maternal mortality. OBJECTIVE: This analysis aimed to assess the service availability and readiness of public health facilities in five provinces of Laos to deliver maternal and newborn healthcare, including basic emergency obstetric and newborn care services (BEmONC). METHODS: A cross-sectional survey was conducted In October-November 2023 across 212 health centers and 20 district hospitals under the Laos Maternal Child Health and Nutrition project. Descriptive analysis was used to analyze the data. Service availability was measured based on the number of facilities and beds relative to the population. Service readiness was measured across three domains: guidelines and trained staff, essential equipment and supplies, and essential medicines. A composite readiness score was calculated as the mean across these domains. BEmONC availability was assessed using the presence of seven signal functions. FINDINGS: The overall service availability score was 71.3% across all provinces. The antenatal care readiness score across both facility types was 69.0%, CI95:62.7-75.3%, with district hospitals scoring higher than health centers, at 77.1%, CI95%:75.4-78.8%, compared to 68.2%, CI95%: 62.1-4.3%. The mean readiness score for delivery and newborn care was 68.3%, CI95%: 59.5-77.1%, with district hospitals again performing better at 81.3%, CI95%:79.7-82.9% compared to 67.0%, CI95%:58.2-75.8% for health centers. CONCLUSION: Critical gaps in maternal and newborn health services remain, particularly in health centers. Investments in staffing, infrastructure, and availability of equipment and medicines is essential to address current gaps, improve service readiness, and contribute to improved quality of care and health outcomes.