Obstetric emergency simulation for evaluation of emergency response in the community

In Bolivia, interventions of the Ministry of Health and the U.S. Agency for International Development /Bolivia's Health program aim to strengthen integral networks. The objective is to coordinate actions carried out by the community, local government, and authorities and health center personnel to respond to obstetric emergencies and contribute to the reduction of maternal morbidity and mortality. To evaluate health network performance, we promoted the use of obstetric emergency simulations. During simulation, participants apply skills and techniques they would use in real cases. Once the simulation is carried out, the evaluators proceed to give back the results at a meeting of personnel of the facilities evaluated, community authorities and the municipal government. Participants analyze and identify problems and develop participatory health plans to strengthen the response to obstetric emergencies. The methodology can have an impact on the “three delays” that cause maternal deaths. The most recent simulation was conducted in the Sultaca community of the Camargo network, which has seven municipalities, population of 100,269. During the year they have provided health services to 64,546 women. A participatory health plan was developed after the simulation, including a promoting a birth plan for the organization in the community; improve the system of reference; purchase of equipment, supplies, local transportation, communication systems and training health personnel to resolve obstetric emergencies. Networks that have used this methodology have successfully advocated with municipal authorities to increase the health budget for the purchase of equipment and communities have strengthened their efforts to respond to emergencies.