The 130th Annual Meeting of APHA

Abstract #38659

Maria Luz Perez, MA, Ruben Tellez, MA, and Luis Tam, MD, DrPH. Project 2000, CARE Peru, Apartado Postal 11-0628, Lima, Lima 11, Peru, 51-1-4317430, perezm@carepe.org.pe

Peru has one of the highest maternal mortality rates in the Americas. Although almost 75% rural pregnant women have at least one prenatal control in a health facility, only 25% use these facilities for their births. The Ministry of Health (MOH) of Peru is currently developing tools to enhance the quality of care during the prenatal controls, so that more pregnant women will be encouraged to have an institutional birth. However, the quality and frequency of the supervision visits that these facilities receive in order to assure compliance to these tools is very limited. In this situation, Project 2000 (a MOH project funded by USAID and implemented by CARE, Pathfinder and Development Associates) tested the use of quarterly self-supervision exercises and application of measurable performance standards to promote a continuous quality enhancement of the prenatal controls and the promotion of institutional births. The results of the self-supervision exercises were compared with the supervision visits by Project 2000 staff. Performance standards included management procedures (e.g. client exit surveys) plus population-based results, e.g. behavior practiced. This one-year test has benefited 30 health centers and hospitals in 12 (out of 24) departments of Peru. Results were impressive. On average, facilities increased their compliance to the performance standards from 47% to 95% in one year. There was also high consistency (more than 80%) between the results of the self-supervision and of the external supervision. The MOH is using these results to explore the nationwide application of self-supervision exercises and performance standards.

Learning Objectives:

• At the end of the presentation, the audience will know the advantages and limitations of using self-supervision exercises and measurable performance standards to enhance the quality of maternal care in government health facilities.

Keywords: Maternal Care, Management

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.