The 130th Annual Meeting of APHA

Abstract #36258

Luis Vega-Centeno, MD, MPH, Raul Luna, MD, and Luis Tam, MD, DrPH. Obstetric Emergencies Project in Ayacucho, CARE Peru, Apartado Postal 11-0628, Lima, Lima 11, Peru, 51-1-4317430, vegal@aya.carepe.org.pe

Rural Peru experiences a maternal mortality ratio of more than 200 per 100,000 live births. Hemorrhage, infection and eclampsia are major causes of maternal mortality. The Peruvian government has declared the reduction of maternal mortality a national priority and is quickly upgrading its facilities and training their staff. In collaboration with this national effort, CARE Peru is implementing a 3-year maternal mortality reduction project in the rural department of Ayacucho. This project is part of the Averting Maternal Death and Disability (AMDD) initiative of Columbia University which is funded by the Gates Foundation. An important CARE-Government collaboration has been the selection of health facilities to be upgraded (and staff to be trained) to manage obstetric emergencies. In contrary to traditional classifications, which privileged administrative mapping or geopolitical considerations, CARE and the Government chose facilities according to three criteria: population density in the facility's catchment area, population flow along the facility's catchment area and the annual number of cases of obstetric emergencies attended. Major discrepancies in the facilities selected appeared by comparing the traditional and the new criteria, but the new criteria were applied by the Government and CARE for the upgrade and training efforts. After 6 months, major improvements in access and quality of care have occurred in the population, as measured by standard UNFPA/WHO indicators. They prove the wisdom of the new criteria. This experience can be useful in other settings (in Peru and abroad) when the government needs criteria to allocate their limited resources in a cost-effective manner.

Learning Objectives:

• At the end of the presentation, the audience will assess the importance of population-based criteria for the selection of facilities to be upgraded in the management of obstetric emergencies.

Keywords: Maternal Care, Health Reform

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Ministry of Health of Peru. CARE Peru.
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I work for CARE Peru.