USAID/Dominican Republic : evaluation of USAID"s intermediate result 4 : increased access to and delivery of quality maternal and child health care services in selected areas in the Dominican Republic : maternal and child health centers of excellence, and maternal and child health integrated program

The Maternal and Child Health Integration Program (MCHIP) complemented CoEx through technical support for high-impact evidence-based newborn health interventions, such as prevention and treatment of sepsis, family-centered maternity and kangaroo mother strategies, strengthening the national newborn health work plan, and use of the Helping Babies Breathe Curriculum to resuscitate newborns. The CoEx has been highly successful, with real impact on the organization and quality of MCH health services in the 10 project hospitals. In all 10 it has met its targets of: (1) bringing strategic plans current; (2) use of self-assessment tools; and (3) training managerial teams. The project has been less successful in reducing the percentage of cesarean sections performed (still high at 44%) and increasing the number of pregnant women who receive HIV test results and post-test counseling. Hospital management ascribed these problems to the structure of the health system, inefficient supervision, and MOH policies. (Excerpt, modified)