La Paz, Bolivia — In the isolated Bolivian municipality of Bermejo, a dusty, jutted road leads past sugar factories to Colonia Linares, a village of 1,500 people with a thriving health center at the forefront of local efforts to prevent women from dying of childbirth complications.
With support from the U.S. Agency for International Development’s (USAID’s) flagship Maternal and Child Health Integrated Program (MCHIP), Colonia Linares Health Center has become a cornerstone of the Bermejo Obstetric Network, equipped with a two-way radio, access to transportation via ambulance, and staff trained in basic emergency obstetric care (BEmOC). MCHIP, through Jhpiego and partners, has worked to develop a comprehensive maternal and reproductive health program and to strengthen delivery of care in key areas.
“These doctors have been trained in the most up-to-date technical norms,” says Dr. Wilber Leyton from SEDES Tarija, the regional office of the Bolivian Ministry of Health that oversees the Bermejo municipality. “This is a model municipality.”
In the past two years, MCHIP has trained 615 health providers, including 265 doctors and 350 nurses and auxiliary nurses across four provinces. As many as 2,450 pregnant women a month attend prenatal care services and are benefitting from the new skills acquired by these health providers.
As part of this work, MCHIP staff provides technical updates in maternal health and BEmOC, as well as supportive supervision to the MCHIP-trained health workers in the Bermejo Obstetric Network and nine other networks. According to the Director of the Bermejo network, Dr. Milton Visacho, in order to keep mothers and their children healthy, “we decided to focus on maternal child health with MCHIP.”
MCHIP builds on Jhpiego’s previous capacity-building efforts in Bolivia, which began in the early 1990s under the USAID-funded Training in Reproductive Health Project. This work included strengthening pre-service education for reproductive health and family planning at two medical and five nursing schools, and supporting the development of policy and strategies to strengthen human resources for health.
Under MCHIP, Jhpiego has also successfully advocated for the implementation of the Standards-Based Management and Recognition (SBM-R®) approach to improve the quality of services in USAID’s four target regions across Bolivia, including Tarija. Of the 71 health facilities where MCHIP has introduced SBM-R, 65 have fully implemented the approach, including conducting a baseline assessment and at least two follow-up monitoring reviews. Forty-one facilities have gone further, to carry out at least three reviews.
This quality improvement project is part of Jhpiego’s ongoing efforts to partner with countries in building the capacity of health care workers and strengthening health systems to prevent the needless deaths of women and families. The organization develops innovative, solutions to address today’s global health challenges and works with communities to increase frontline health workers’ ability to deliver lifesaving care.
In Colonia Linares, MCHIP’s efforts have led to a two-fold advantage in saving lives. First, fewer obstetric emergencies need to be referred to the hospital in Bermejo, lessening the load on the staff there. Second, the decentralized provision of services at Colonia Linares Health Center means fewer delays for women facing obstetric emergencies—delays in reaching a health facility and in receiving quality services once at a facility.
Reducing these delays has contributed to continued health improvements for the families of Colonia Linares, where not a single maternal death has occurred in the health center’s responsible area since 2005, according to local officials. MCHIP envisions that its capacity-building efforts will support other health facilities in Bolivia to follow the Colonia Linares’ example.