Improving Maternal Health in Peru: Removing Cultural Barriers to Safe Delivery

APHA Scientific Session and Event Listing

Varuni Dayaratna, MPA¹, Maria Rosa Garate², and Patricia Mostajo². (1) Futures Group, A Constella Company, One Thomas Circle, NW, Suite 200, Washington DC, DC 20005, 202-777-0706, vdayaratna@futuresgroup.com, (2) Futures Group - Peru, Avenida La Paz 596, Miraflores, Lima, Peru

With the Maternal Mortality Ratio (MMR) at 185 per 100,000 live births, maternal mortality in Peru is one of the highest in Latin American. Moreover, the MMR varies significantly by geographic region, with some low-income regions reporting maternal mortality rates of above 500. Underlying the high mortality rates is the fact that women in Peru often opt to deliver at home, in many instances, with unskilled birth attendants and with no possibility of accessing professional care in case of complications.

Responding to this situation, the USAID-funded POLICY Project conducted a study to identify and eliminate barriers that impede access to safe delivery care for low-income women in areas with high maternal mortality. One of the principal barriers identified through secondary and primary research, and prioritized during workshops with stakeholders included the disregard for local cultural practices at facilities, which served as a disincentive for women seeking institutional care for their deliveries. POLICY worked closely with local authorities in one study site to set in place norms and interventions to address this problem.

Subsequently, the Ministry of Health in Peru issued a Resolution mandating the development and implementation of new delivery protocols that incorporate local cultural practices in health establishments throughout the country. These protocols, which are intended to make maternal care services more palatable for women, are based on practices that were adopted in the study site, as a direct result of POLICY's research and subsequent pilot interventions. This paper presents the experience in Peru, from research to policy change.

Learning Objectives:

At the conclusion of this session, participants will be able to

1. Articulate some of the principal barriers that low-income rural women face when they seek skilled care during delivery.
2. Discuss and replicate a successful policy intervention that removed an important barrier to institutional delivery in a high maternal mortality setting.

Presenting author's disclosure statement:

Not Answered

The Right to Positive Pregnancy Outcomes: Barriers to Care and Other Issues

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA