Online Program

Maternal & child centers of excellence: Boosting provider motivation & improving health outcomes

Wednesday, November 6, 2013 : 1:10 p.m. - 1:30 p.m.

Carlos Cuellar, MD, MPH, International Health Division, Abt Associates, Inc., Bethesda, MD
The USAID-funded Maternal and Child Centers of Excellence (COEx) project works with the Dominican Republic's MOH to reduce maternal and neonatal mortality. With a focus on enhancing intrinsic motivation and ownership,. providers and managers were trained on emergency obstetric and neonatal care, customer service, biosafety and infection prevention, and use of management information systems.

The project developed 10 public hospitals as COEx to create a cohort of positive deviants that would both demonstrate impact on morbidity and mortality indicators, and share best practices and lessons learned with other hospitals nationwide. A system of 18 standards and competitive scoring was used to measure each facility's progress towards certification as a COEx.

As a result of the intervention, use of active management of the third stage of labor ( increased from 32% to 95% and maternal deaths decreased from 201 in 2010 to 168 (-16.4%) in 2011. The number of maternal deaths at the 10 intervention hospitals was cut by 49.2% as tracked by the MOH epidemiological surveillance system.

Conclusions: It is possible to develop an environment that nurtures intrinsic motivation in provider teams. A structured certification system harnessed motivational forces that promoted both clinical and managerial behavior change, resulting in tangible health impact. In 2012, the project was selected as one of only four projects highlighted at a joint US Senate joint USAID event featuring countries that have made significant advances in reducing maternal death.

Learning Areas:

Provision of health care to the public

Learning Objectives:
Describe the Maternal & Child Centers of Excellence model that is being applied the Dominican Republic, and demonstrate the impact is aving in reducing both maternal and neonatal mortality.

Keyword(s): Maternal and Child Health, Quality Assurance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract Author on the content I am responsible for because I was the Director from 2009-2012 of the Maternal & Child Centers of Excellence project (subject of the presentation) in the Dominican Republic. I am an MD with an MPH degree and a Diploma in Tropical Medicine with over 25 years of experience in global health. I am currently the Portfolio Manager of the above mentioned project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.