3055.0: Monday, October 22, 2001 - Board 5

Abstract #26485

Rights, readiness and response: Improving the quality of maternity services to prevent maternal death

Amy E. Pollack, MD, MPH1, Karen J. Beattie, MA1, and Judith A. Graeff, PhD, MPH2. (1) EngenderHealth, 440 Ninth Avenue, 3rd floor, New York, NY 10001, (212) 561-8000, apollack@avsc.org, (2) Columbia University, New York, NY

Although 600,000 women die each year of pregnancy and childbirth related causes, and many more suffer injuries and disabilities, most of the causes of maternal mortality are preventable. An estimated fifteen percent of all pregnant women develop pregnancy-related complications requiring obstetric care. Community-level interventions play an important role in influencing decisions to seek care; however, once care is sought, the facility's ability to handle complications promptly and proficiently is critical to preventing maternal mortality. After more than a decade of initiatives to reduce maternal mortality, evidence from pilot projects suggests that while individual interventions have had a local impact on reducing maternal mortality, the number of maternal deaths is not diminishing overall. There is a need for an integrated package of interventions that improves the quality of care at facilities - assuring high quality basic emergency obstetric care at the community health center level and access to comprehensive emergency obstetric care - and that links with communities. This requires both improving clinical aspects of care and changing attitudes and behaviors of facility staff toward clients' needs and community beliefs. Health providers in facilities need institutional support and concrete tools, to allow them to play a proactive and sustainable role in improving quality and to ensure that the services they provide meet local needs. We will present a framework to help providers ensure that they are ready to respond to the needs of their clients, in a manner consistent with clients' rights as women and as consumers of health services.

Learning Objectives: At the end of this session, participants will be able to: 1)Discuss community- and facility-based approaches to reducing maternal mortality in developing countries. 2) Articulate the principles of a quality improvement framework for emergency obstetric care that incorporates facility readiness and appropriate clinical response to obstetric emergencies with an awareness of clients' rights and community needs.

Keywords: Maternal Care, Quality of Care

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Funding has been received from the Averting Maternal Death and Disability Project of Columbia University for the work discussed in this presentation

The 129th Annual Meeting of APHA