Care Packages at the Primary and Secondary Levels| Level of care and condition | Content | Base package | Enhanced package |
| Routine prenatal care at the primary levela | Clinical examination, including for severe anemia, height and weight, blood pressure | X | X |
| Obstetric examination for gestational age estimation and uterine height, fetal heart, detection of malpresentation and position, and referral | X | X |
| Gynecological examination | X | X |
| Urine test (multiple dipstick) | X | X |
| Laboratory tests: hemoglobin, blood type and rhesus status, syphilis and other symptomatic testing for sexually transmitted diseases | X | X |
| Advice on emergencies, delivery, lactation, and contraception | X | X |
| Education about clean delivery, warning signs, and premature rupture of membranes | X | X |
| Iron and folic acid supplementation | X | X |
| Multivitamin supplementation | — | X |
| Tetanus toxoid immunization | X | X |
| HIV voluntary testing and counseling | — | X |
| Antimalarial chemoprophylaxis in endemic areas | — | X |
| Screening and treatment for syphilis | X | X |
| Balanced protein-energy supplementation for all women | — | X |
| Delivery care at the primary levelb | Clean delivery technique, clean cord cutting, clean delivery of baby and placenta | X | X |
| Active management of the third stage of labor, including oxytocics | X | X |
| Episiotomy in appropriate cases | X | X |
| Recognition and first-line management of delivery complications (for example, obstructed labor, early detection of cephalopelvic disproportion, malposition and malpresentation, previous cesarean delivery, postpartum hemorrhage, and preeclampsia or eclampsia) and referral | X | X |
| Intravenous fluid | X | X |
| Intravenous uterotonics, if bleeding occurs | X | X |
| Partograph | X | X |
| Essential newborn care | X | X |
| Intravenous antibiotics | X | X |
| Magnesium sulfate | — | X |
| Forceps or vacuum extraction | — | X |
| Manual removal of placenta | — | X |
| Removal of retained products of conception | — | X |
| Corticosteroids for preterm labor | — | X |
| Antiretrovirals for prevention of mother-to-child transmission of HIV | — | X |
| Antibiotics for premature rupture of membranes | — | X |
| CEmOC package at the secondary levelc |
| Postpartum hemorrhage | Recognition of high-risk cases and arrangements for delivery in a facility | X | X |
| Grouping of blood | X | X |
| Iron and folate supplementation | X | X |
| Blood transfusion | X | X |
| Uterotonic drugs, oxytocics | X | X |
| Bimanual compression of uterus | X | X |
| Manual removal of placenta | X | X |
| Uterine packing or balloon tamponade | X | X |
| Fluid replacement | X | X |
| Hysterectomy | X | X |
| Removal of products of conception | X | X |
| Secondary postpartum hemorrhage management (antibiotics, uterotonics, removal of products of conception, and fluid and blood replacement) | X | X |
| Antepartum hemorrhage | Early detection of major placenta previa and abruption | X | X |
| Grouping and saving blood | X | X |
| Iron and folate supplementation | X | X |
| Cesarean section for major-degree placenta previa, abruption with a live baby | X | X |
| Blood and fluid replacement | X | X |
| Oxytocics | X | X |
| Sepsis | Antibiotics for premature rupture of membranes, cesarean section | X | X |
| Fluid and blood transfusion | X | X |
| Intravenous antibiotics | X | X |
| Evacuation of products of conception | X | X |
| Drainage of abscess | X | X |
| Treatment of shock with fluids or blood, nitroglycerine | X | X |
| Pregnancy-induced | Early detection and management of preeclampsia | X | X |
| hypertension | Calcium supplementation in high-risk cases | X | X |
| Aspirin to prevent preeclampsia | X | X |
| Antioxidants to prevent preeclampsia | X | X |
| Intravenous magnesium sulfate | X | X |
| Antihypertensive drugs to reduce blood pressure | X | X |
| Immediate delivery if more than 36 weeks | X | X |
| Magnesium sulfate and antihypertensives for postpartum eclampsia | X | X |
| Obstructed labor | Partograph | X | X |
| Cesarean section | X | X |
| Symphysiotomy | X | X |
| Destructive operation | X | X |
| Antibiotics | X | X |
| Fluid and blood transfusion | X | X |
| Hysterectomy | X | X |
| Abortion | Evacuation of retained products of conception | X | X |
| Intravenous antibiotics | X | X |
| Fluid or blood transfusion | X | X |
| Postabortion contraceptive advice | X | X |
| Ectopic pregnancy | Proof puncture (culdocentesis) | — | — |
| Laparotomy and salpingectomy | — | — |
| Blood transfusion (autotransfusion) | X | X |
| High-risk infant | Forceps or vacuum extractiond | X | X |
| Corticosteroids for preterm labor | — | X |
| Antiretrovirals for prevention of mother-to-child transmission of HIV | — | X |
| Antibiotics for premature rupture of membranes | — | X |
