‘It needs a complete overhaul…’ district manager perspectives on the capacity of the health system to support the delivery of emergency obstetric care in an urban South African district

Figures & data

Table 1. Analytical themes related to the health system building blocks.

Health system building blocks framework	Emerged themes
1. Organisation of EmOC services	Dual organisation of EmOC
	More health facilities for EmOC required
2. Leadership and governance	Clear vision guiding all managers
	Poor coordination of EmOC and fragmented care
	Duplication of management efforts
	High vacancy and turnover of senior management overseeing EmOC
3. EmOC staffing challenges	Acute shortage of skilled EmOC providers
4. Finance	Budgetary constraints failing implementation of new management plans
	Lack of funding a barrier to recruitment of senior managers
5. Drugs, equipment, and supplies	Procurement challenges frustrating managers
6. Health information	Need for improvement of health systems indicators
	Data clerks needed to administrate patient files in health facilities