Health system funders, designers, and managers need to develop
and rollout sustainable plans for ensuring that the necessary human
resources, skills, and equipment are in place in a structured manner
at each level of the health system. As transfer to another facility during
the second stage of labor is very problematic and is likely to be associated
with poor outcomes because of the additional delay, every
effort should be made to provide the assisted vaginal delivery component
of Basic Emergency Obstetric Care so that delivery can be
effected at health center level without the need for transfer.