‘She was referred from one hospital to another’: evidence on emergency obstetric care in Karnataka, India

Introduction Launching of the the National Rural Health Mission (2005) has brought a sharp policy attention to maternal health with its several initiatives such as (a) cash and material benefits to pregnant women; (b) strengthening health institutions especially of First Referral Units (FRUs); and (c) conducting regular maternal death audits to ensure quality Emergence Obstetric Care (EmOC). In spite of these efforts, the decline in maternal mortality ratio is rather slow and not achieved as per the MDG 5 goal. This study was undertaken to understand why despite infusion of such vast resources into the health system, timely and quality EmOC services have not been implemented.