Ecuadorian Ministry of Health Adopts URC Affiliate's Essential Obstetric and Newborn Care Model

The Ecuadorian Ministry of Health (MOH) plans to expand the Essential Obstetric and Neonatal Care (EONC) network model countrywide. The model is part of a national initiative to reduce maternal and newborn mortality.

Since 2009, URC's nonprofit affiliate, the Center for Human Services (CHS), piloted the model to improve equitable coverage and quality of essential maternal and newborn health care services, including home- and facility-based care immediately following childbirth, by trained traditional birth attendants (TBAs) and skilled providers. With support from the US Agency for International Development (USAID) Child Survival and Health Grants Program (CSHGP), CHS designed and implemented the model in close alliance with the national and provincial MOH, USAID, PVO/NGOs, providers, and users.

The model uses a comprehensive province-level network that coordinates public and private community- and facility-based services and promotes coordinated service delivery. As part of a deliberate equity strategy, the network supports increased coverage and improved quality of care in the most vulnerable and marginalized (primarily indigenous) communities in Cotopaxi province, including at health care centers and county hospitals.

Initial findings from a project evaluation conducted in July/August include:

  • The EONC Cotopaxi network contributed to improvements in:
    • Household maternal best practices, including:
      • Exclusive breastfeeding – from 38% to 51%
      • Naming neonatal danger signs – from 75% to 97%
      • Birth preparedness – from 57% to 73%
      • TBA referral of complications from home to facility – from 50% to 83%
      • Client satisfaction – from 65% to 98%
    • Visits within two days of birth – from 4% to 70%
    • Trends in reducing neonatal mortality
  • The model recommended key improvements, including:
    • Coordination and networking across all levels
    • Short courses to improve the quality of care and continuous improvement
    • Improved clinical knowledge to manage complications of childbirth
    • Culturally appropriate communication and management of health care provision
  • Quality of services was nearly universally improved in project sites; compliance with newborn care standards in facilities increased from 13% to 50%.

About the Child Survival and Health Grants Program

The Child Survival and Health Grants Program (CSHGP) supports new partnerships among NGOs, academia, and Ministries of Health to generate evidence about how to solve critical challenges in the implementation and expansion of high-impact maternal, newborn, and child health approaches. Since 2008, the CSHGP has supported 19 international NGOs and their local partners in 23 countries to implement and test innovative solutions tailored to local contexts, with relevance to both global and national implementation challenges. These projects have contributed both to moving community-oriented solutions into the policy dialogue and to expanding them to the national level to support countries in accelerating strategies to end preventable child and maternal deaths. 

CSHGP’s partnership with CHS in Ecuador reinforces the idea that strong partnerships for learning and action with the MOH can result in national level policy and strategy impact. The EONC network model will continue to be adapted within Ecuador as appropriate to the setting and can be globally adapted across countries.

Double image: people carry a person wrapped in a blanket and an ambulance stopped on a dirt road.
Community members carry a woman having labor complications from her home to an ambulance, which transports her to a nearby hospital, where she delivers a healthy baby girl. Photo by Dr. Mario Chávez.
Date 
September 06, 2013
Authors 
Kathleen Hill, Deputy Director, USAID ASSIST Project, and Communication Department staff
Regions/ Countries