BACKGROUND Within each of the Sustainable Development Goals (SDGs), the World Health Organization (WHO) has identified key emergency care (EC) interventions that, if implemented effectively, could ensure that the SDG targets are met. The proposed EC intervention for reaching the maternal mortality benchmark calls for "timely access to emergency obstetric care." This intervention, the WHO estimates, can avert up to 98% of maternal deaths across the African region. Access, however, is a complicated notion and is part of a larger framework of care delivery that constitutes the approachability of the proposed service, its acceptability by the target user, the perceived availability and accommodating nature of the service, its affordability, and its overall appropriateness. Without contextualizing each of these aspects of access to healthcare services within communities, utilization and sustainability of any EC intervention-be it ambulances or simple toll-free numbers to dial and activate EMS-will be futile. MAIN TEXT In this article, we propose an access framework that integrates the Three Delays Model in maternal health, with emergency care interventions. Within each of the three critical time points, we provide reasons why intended interventions should be contextualized to the needs of the community. We also propose measurable benchmarks in each of the phases, to evaluate the successes and failures of the proposed EC interventions within the framework. At the center of the framework is the pregnant woman, whose life hangs in a delicate balance in the hands of personal and health system factors that may or may not be within her control. CONCLUSIONS The targeted SDGs for reducing maternal mortality in sub-Saharan Africa are unlikely to be met without a tailored integration of maternal health service delivery with emergency medicine. Our proposed framework integrates the fields of maternal health with emergency medicine by juxtaposing the three critical phases of emergency obstetric care with various aspects of healthcare access. The framework should be adopted in its entirety, with measureable benchmarks set to track the successes and failures of the various EC intervention programs being developed across the African continent.

中文翻译：

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妇女的价值：在撒哈拉以南非洲，将急诊医学与孕产妇保健相结合以减少孕产妇死亡负担的获取框架。

背景技术在每个可持续发展目标（SDG）中，世界卫生组织（WHO）已经确定了关键的紧急护理（EC）干预措施，这些干预措施如果得到有效实施，可以确保实现SDG目标。为达到产妇死亡率基准而提议的欧共体干预措施要求“及时获得紧急产科护理”。据世卫组织估计，这种干预措施可避免整个非洲地区多达98％的孕产妇死亡。但是，获取是一个复杂的概念，并且是较大的护理服务框架的一部分，该框架构成了拟议服务的可及性，目标用户的接受程度，服务的可感知可用性和可容纳性，可负担性及其整体适当性。如果不对社区内获得医疗服务的所有这些方面进行情境化，那么任何EC干预措施的利用和可持续性（无论是救护车还是拨打和激活EMS的简单免费电话）都是徒劳的。正文在本文中，我们提出了一个访问框架，该框架将孕产妇保健中的“三延迟模型”与紧急护理干预措施相结合。在这三个关键时间点中的每个时间点，我们提供了为何应将预期干预措施与社区需求相结合的原因。我们还在每个阶段提出可衡量的基准，以评估框架内拟议的EC干预措施的成败。框架的中心是孕妇，她的生活在个人和健康系统手中处于微妙的平衡状态，这些因素可能会或可能不会在她的控制范围内。结论如果没有将产妇保健服务与急诊医学进行有针对性的整合，就不可能实现降低撒哈拉以南非洲产妇死亡率的目标可持续发展目标。我们提出的框架通过将急诊产科护理的三个关键阶段与医疗服务的各个方面并列，将孕产妇保健与急诊医学领域整合在一起。该框架应全部采用，并设定可衡量的基准，以跟踪正在整个非洲大陆制定的各种欧共体干预计划的成败。结论如果没有将产妇保健服务与急诊医学进行有针对性的整合，就不可能实现降低撒哈拉以南非洲产妇死亡率的目标可持续发展目标。我们提出的框架通过将急诊产科护理的三个关键阶段与医疗服务的各个方面并列，将孕产妇保健与急诊医学领域整合在一起。该框架应整体采用，并设定可衡量的基准，以追踪在整个非洲大陆制定的各种欧共体干预计划的成败。结论如果没有将产妇保健服务与急诊医学进行有针对性的整合，就不可能实现降低撒哈拉以南非洲产妇死亡率的目标可持续发展目标。我们提出的框架通过将急诊产科护理的三个关键阶段与医疗服务的各个方面并列，将孕产妇保健与急诊医学领域整合在一起。该框架应整体采用，并设定可衡量的基准，以追踪在整个非洲大陆制定的各种欧共体干预计划的成败。我们提出的框架通过将急诊产科护理的三个关键阶段与医疗服务的各个方面并列，将孕产妇保健与急诊医学领域整合在一起。该框架应整体采用，并设定可衡量的基准，以追踪在整个非洲大陆制定的各种欧共体干预计划的成败。我们提出的框架通过将急诊产科护理的三个关键阶段与医疗服务的各个方面并列，将孕产妇保健与急诊医学领域整合在一起。该框架应整体采用，并设定可衡量的基准，以追踪整个非洲大陆正在制定的各种欧共体干预计划的成败。