Ecuadorian MOH to Expand CHS’s Newborn Health Pilot

After two years of successfully piloting CHS's Essential Obstetric and Newborn Care (EONC) Network Project in Ecuador's Pujilí District, Cotopaxi's Provincial Directorate of Health has announced it will expand the project. Funded by the US Agency for International Development (USAID) Child Survival and Health Grants Program and managed by CHS, the project has made significant gains in maternal and newborn care in the district, halving the number of newborn deaths and eliminating maternal deaths from childbirth. The former dropped from 15 in 2009 to 7 each for 2010 and 2011, and the latter fell from 3 in 2009 to 2 in 2010 and to 0 in 2011, according to the National Institute of Statistics and Census.   

Ministry of Health (MOH) officials plan to expand the project to cover all of Cotopaxi province and three new ones: Chimborazo, Tungurahua, and Pastaza.  "The best way to honor the population—the ultimate expression of public policy—is to reduce maternal and newborn mortality, and that is what the EONC Network Project in Cotopaxi Province is doing," said Dr. Francisco Vallejo, Under Secretary of Governance of the MOH, during a ceremony held in Latacunga last month. 

The project features a province-wide network to support the delivery of basic maternal and newborn services. The network links hospitals (each province has one hospital and several districts; each district also has one hospital) with community-level services. Furthermore, each district has several parishes, and the project set up micro-networks that integrate public providers (MOH and Social Security programs) and nongovernmental organizations (World Vision, Plan International, and the Claudio Benatti de Zumbahua Hospital) as well as traditional birth attendants and community leaders.  

These innovative micro-networks include traditional midwives and community groups that generate referrals of pregnant women and babies with maternal and newborn complications to public facilities. "The midwives have been our point of entry for [reaching] communities and families," said a local physician. "When institutions collaborate, more lives can be saved."    

In addition to reducing maternal and newborn deaths, the project has:

Improved the quality of care (90% of obstetric cases now meet quality standards); 
Created an inter-institutional cadre of "coaches" (MOH and hospital staff) who are strengthening the clinical skills of providers;
Instructed 70 professionals in the Helping Babies Breathe method of newborn resuscitation and 120 traditional midwives in evidence-based birthing practices; and
Applied techniques developed by CHS with the Tungurahua Provincial Health Directorate to make delivery care services more responsive to the cultural preferences of local communities. 

"If, based on this experience, the Ministry of Health can reduce maternal and neonatal mortality in a similar way in more provinces, it will be an enormous achievement for Ecuador," said Dr. Jorge Hermida, CHS Director for Latin America. 

The EONC Network is an important step forward in pursuit of the basic right to health of women and newborns in Cotopaxi.  As the project expands across the country, CHS will continue to share experiences with the MOH and the wider development community.

EONC network leaders during a March 2012 meeting in Cotopaxi (from left): Dr. Alejandro Vargas, Mrs. María Nicolasa Tipán, Mr. Olmedo Pallo, and Dr. Samia Guevara.
EONC network leaders during a March 2012 meeting in Cotopaxi (from left): Dr. Alejandro Vargas, Mrs. María Nicolasa Tipán, Mr. Olmedo Pallo, and Dr. Samia Guevara.
Date 
May 14, 2012
Authors 
Ximena Gudiño, Communications Specialist for the CHS Child Survival Health Grants Program, and Sarah Whitmarsh, URC Communications Specialist
Regions/ Countries