Recorded presentation

Lani Rice Marquez, MHS¹, Jorge Hermida, MD², Luis Fernando Vieira, MD², Luis Urbina, MD³, and Norma Aly, MD³. (1) Quality Assurance Project/University Research Co., LLC, 7200 Wisconsin Avenue #600, Bethesda, MD 20814-4811, 301-941-8431, lmarquez@urc-chs.com, (2) Quality Assurance Project, University Research Co., LLC, Colon 720 y Almagro, 5to piso, Edificio El Cisne, Oficina CD, Quito, Ecuador, (3) University Research Co., LLC, Quality Assurance Project, Km 5, carretera a Masaya, Edificio Fountain Blue, Segundo Piso, Modulos 11 y 12, Managua, Nicaragua

Lack of access to skilled attendance at birth and essential obstetric care (EOC) and poor quality of care are underlying causes of many preventable maternal deaths in Latin America. As part of the USAID Regional Maternal Mortality Reduction Initiative being implemented in partnership with the Pan American Health Organization, the Quality Assurance Project (QAP) is working with the Ministries of Health of Ecuador, Honduras, and Nicaragua to apply the Improvement Collaborative approach to scale up EOC systems in one or more entire regions in each country. The goal is to establish functioning EOC systems that apply best practices in maternal and neonatal care, such as correct use of the partograph, active management of third stage labor, outreach to communities to raise awareness of danger signs of obstetrical complications among families, assuring access to blood, and essential newborn care. The improvement collaborative approach uses principles of diffusion of innovation and shared learning among participating teams to accelerate the pace of improvement. The presentation will describe the development and results of the EOC Collaborative from mid-2003, when national coordinating groups were formed in each country, through the third and fourth action periods of the collaborative in mid-2004, when improvement teams have applied rapid, incremental improvements and monitored key indicators of the performance of their EOC system each month. The presentation will also discuss the effectiveness of an interactive website, listserv, and face-to-face meetings in facilitating sharing of ideas and learning between teams and between countries.

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