| Project Detail |
Although Bolivia has experienced significant improvements in maternal and child health indicators in recent years, the maternal mortality rate remains high at 155 (per 100,000 live births) (2017, UNICEF), compared to the SDG target (below 70 (per 100,000 live births) by 2030). In response to this challenge, the Bolivian government has undertaken policies focused on improving maternal and child health services in the community with the Comprehensive Development Sector Plan for Living Well 2016 - 2020. In addition, in the last 20 years, JICA has implemented technical cooperation projects to strengthen maternal and child health in the community, and implemented activities to improve the health of the population. As a result, access to medical facilities has improved and rates of prenatal check-ups and institutional deliveries have increased. Although access to medical centers has improved, one of the factors contributing to maternal and neonatal deaths is insufficient coordination of patient referrals and counter-referrals between hospitals. In order to expand the referral/counter-referral system throughout the country, the Bolivian government has established Health Emergency Coordination Centers in each department, to coordinate emergency medical services. However, the practical protocols of each center have not been developed and do not work correctly. Inadequate referrals to higher level medical centers and delays in referrals due to lack of knowledge and skills of medical personnel are also considered causes of maternal and neonatal deaths. Therefore, it is necessary to improve the capacity of health professionals to improve this situation, and the improvement in primary and secondary care centers is especially important. In addition, analysis of maternal and neonatal deaths is essential to understand the bottlenecks that cause deaths, and feedback based on the analysis is important to improve the quality of maternal and newborn health services. However, maternal mortality review committees at department, municipality and hospital levels do not meet regularly to provide adequate review and feedback. It is expected that this committee will be convened to reinforce the communication of the analyzes and recommendations of the health offices of the departments, to the medical institutions of each level. In this context, the project will target the department of Santa Cruz to strengthen the functions of the Health Emergency Coordination Center, improve the technical capacity of health workers in primary and secondary care centers with regard to referrals and maternal and neonatal counter-referrals, and improve the quality of maternal and child health services. By supporting the strengthening of an adequate analysis of maternal mortality, it is expected that maternal and child health services are adequately provided, thus contributing to the improvement of the state of maternal and neonatal health. |
