Success Story

Training to Reduce Maternal Mortality

The Emergency Obstetric Care courses teach health care providers improved clinical practices and improve emphatic treatment of patients

At 9:00 am on a Friday morning, 13 women are in labor at La Altagracia Maternity Hospital in Santo Domingo. In one corner of the delivery room are Dr. Ayala and Regina, who is in labor with her 4th child. From afar, you can see her resting her head on the doctors’ chest between contractions. As you step closer you can hear him whisper reassuring words to her.

Dr. Ayala is one of the dozens of health care providers, from 7 city hospitals, that have benefited from the USAID-sponsored Emergency Obstetric Care courses (EOC). These courses are designed to teach health care providers improved clinical practices, and are complemented by an emphasis on being more empathetic with their patients, as an initiative to improve the quality of health care and assure that the obstetric emergencies that threaten the lives of mothers are treated appropriately.

The USAID-sponsored Demographic Health Survey of 2002 reported that the maternal mortality rate in the Dominican Republic is 178 of every 100,000 births, a surprisingly high rate. The survey goes on to show that the causes of maternal death are often preventable occurrences, such as hemorrhaging or infection. The EOC training is intended to prevent those cases of maternal death, where timely and appropriate care can make all the difference.

The course also strengthens team work in the hospital. “There is more integration with the nursing personnel, to help them determine what their role is,” says Dr. Cid, Hospital Director. “Nurses are more dedicated to their patients, and are better equipped to identify problems, such as hemorrhages, and to manage drug administration. They are practicing preventive medicine”.

Milkeida, a patient that lies in a bed next to her newborn (her third) says that she is very happy with her doctor’s care. “I always get good doctors here,” she says, explaining that during her labor, they allowed her husband to accompany her, and the doctors would check on her regularly.

Accompanying a woman during labor is not common in Dominican public hospitals, but as a result of the course’s emphasis in humane obstetric care, the hospital now allows the younger patients to have a family member present.

In addition, doctors and nurses from municipal hospitals who traditionally referred patients to La Altagracia, are now going there for training. “When they come, they see that they can provide much of this care themselves and under better conditions, because they have fewer patients,” says Dr. Luis Suárez, a trainer for the EOC course, working with USAID partner Profamilia.

On a whiteboard in the classroom where the hospital staff met six hours a week for three weeks, the students leave proof of the lessons learned with affirmations such as “we have been sensitized,” and “we have good motivation”. This motivation, the course results have shown, makes all the difference in ensuring safe motherhood.