Strengthening Clinical Services and Health Systems Management in Bolivia
The purpose of the Health Management and Quality Project is to strengthen the public health system in order to improve service quality and coverage, especially in child health, maternal and neonatal health, and infectious diseases.
In Bolivia, the Council is working with John Snow, Inc. to improve responses to obstetric and neonatal emergencies based on locally identified needs. Photo: Uri Carrasco.
Since July 2005, with USAID funding and a subcontract from John Snow, Inc, the Population Council has been part of the Health Management and Quality Project, to which Council researchers contribute in three main areas: operations research, monitoring and evaluation, and continuous quality improvement programs.
The project seeks to improve clinic-based health service delivery and management capacity at the local level (health networks and municipalities) through a combination of activities. Implementing a continuous quality improvement (CQI) program in 50 percent of the 33 health networks is one of four key initiatives; the CQI program focuses on improving the management of child malnutrition and tuberculosis diagnosis and treatment. The second is to expand the use of evidence-based interventions to diminish maternal mortality and neonatal mortality, particularly from postpartum hemorrhage and asphyxia, infections, and prematurity. Third, the program aims to conduct operations research to identify best practices; alternative solutions to identified problems; evaluation methods; and needs for diagnostic, behavioral, financial, or intervention-related research. The final and summary program initiative is to institutionalize these interventions in Bolivia's health system.
Since 2007, the Population Council has completed several studies:
- Investigated the effects of the supplementary food Nutribebé on children’s nutrition and health;
- Explored the introduction of practices beneficial to mother and child health during delivery (immediate breastfeeding, early skin-to-skin contact, delayed clamping of the umbilical cord, and active delivery management);
- Evaluated strategies to improve communication between health providers and their clients;
- Examined ways to improve the diagnosis and treatment of neonatal infections; and
- Analyzed perceptions of the community on care for obstetric and neonatal emergencies.
Banner photo: Uri Carrasco
Strategies to introduce in the clinical practice the delayed clamping of the umbilical cord to diminish child anemia (abstract) (PDF)
Presentation at the 12th World Congress on Public Health, Istanbul, 29 April
Publication date: 2009
Duration: 5/2005 - 6/2010
Arminda Moron (Children's Hospital, Santa Cruz)
Darwin Martínez (president, Bolivian Society of Pediatrics)
Ministry of Health, Bolivia, Unit of Health Services and Quality
Monica Gironas (biochemist)
Renata Schumacher (Gestion y Calidad en Salud)
John Snow, Inc
US Agency for International Development