Maternal and Newborn Care. A comparison of baseline and final KPC results show marked improvement in prenatal visits (from 26% to 48%) and in deliveries attended by someone trained in safe birthing techniques (from 8% to 30%). Although the objectives for this component were not met, the CS Project has been effective in changing behaviors, demonstrated by an increase of over 20% for both indicators.
Maternal and Newborn Care. ❑ Changes made at health centers, based on the results of the ethnographic study, have increased the utilization of maternal care services. ❑ The inclusion of an Aymara educator and giving her basic CS training was an excellent way to begin working with women’s groups and to motivate women to adopt new health practices. Family Planning ❑ Depo-Provera has been very well accepted by the project area population. ❑ Educational cards (cartillas) have been useful in home visits. ❑ Use of fairs and markets to promote family planning has been a successful strategy. ❑ Competition games for increasing family planning knowledge have been successful.
Maternal and Newborn Care. ❑ Continue to assist health personnel and health facilities to make changes, based on the results of the ethnographic study. ❑ Expand training of men and health volunteers in safe birthing practices and continue to promote the clean birth kit. ❑ Consider training ANs in life saving skills. MotherCare developed a training program for level 1 of the Bolivia Health Care System in life saving skills, along with protocols for treatment of obstetric and neonatal emergencies. MotherCare also has a Path to Survival Model for obstetric and neonatal care, which would be of interest to CSRA, along with a set of educational materials. Family Planning ❑ Emphasize improving quality in family planning based on the following: information, availability of methods, technical competence, follow-up mechanisms, consolidation of services, and interpersonal relations. ❑ Implement a communication for behavior change strategy to increase family planning users, building upon the successes to date (e.g. home visits, fairs and markets, competitions, and games). ❑ Study alternatives to improve the supply system for contraceptives. ❑ Consider working through the MHBs to attain greater synergy between rural schoolteachers and health personnel. Schools provide a captive audience for health education, and students will soon be mothers and fathers with children of their own. Behavior change is much easier for younger people, and this may be a more cost-effective investment for lasting changes in health behavior. Municipal Health Systems ❑ Improve the process of feeding back programmatic and financial information to municipal health boards. ❑ Develop a systematic plan for strengthening municipal health boards, including training in group decision making, building leadership, conflict resolution, and planning. ❑ Improve the health facility-community relationship through additional research regarding the definition of “quality” from the Aymara point of view, followed by a social marketing strategy to improve utilization and coverage of health services. ❑ Apply the model used in the Municipality of Puerto Xxxxxx, where an inter-sector committee was formed to address issues in the areas of health, education, infrastructure, transportation, and agricultural production. Health Facilities Strengthening ❑ Although the central level of CSRA in La Paz keeps good records of all financial transactions, the feedback of this information to partners needs to be improved. It is important that all parties r...
Maternal and Newborn Care. Although coverage for prenatal care was low in the survey (as recorded on antenatal cards), these results are most likely due to poor retention of antenatal cards. The high coverage of self-reported IPT indicates that prenatal coverage is much higher. Although the project will work with community volunteers and health workers to continue to promote prenatal care, the main focus will remain on increasing postpartum care coverage and assisted deliveries. The survey confirmed earlier data that use of Trained Traditional Birth Attendants is very low, and the project will need to work closely with communities to increase that coverage when families choose home births.
Maternal and Newborn Care. Mothers continue to favor TBA-assisted deliveries in their homes compared to assisted deliveries at health facilities; because district-based health facilities are not easily accessible to the public, (they are located far away from the villages (regulados). • Mothers knowledge regarding clean and safe delivery are very high and all interviewed mothers confirmed that they would not give birth without previously purchasing a clean birth kit. • A large number of Community Leaders Council (CLC) members have been trained to facilitate the dissemination of information and the expansion of IEC activities in the communities, especially about the promotion of prenatal care and the vaccination of mothers and children. • TBAs’ efforts to promote clean and safe deliveries were also recognized as being high in the communities, however collaborative efforts must continue with the CLCs to ensure the establishment of functional councils that can plan for emergency evacuation of women with complications at delivery, as well as ensure the maintenance and repair of bicycle ambulances.
Maternal and Newborn Care. Desired Result: Improved Quality of Maternal and Newborn Care and Target Population Knowledge Intermediate Results (Outcomes):
Maternal and Newborn Care o Ensure availability of emergency obstetric and newborn care services. o Establish a 24/7 referral system for obstetric emergencies. o Provide clean delivery packages to visibly pregnant women and trained birth attendants.
