[Using indicators to identify regions with critical maternal health conditions].
OBJECTIVE
In early 2000 the Ministry of Health and Social Welfare of Bolivia brought together a group of experts who, using available information, developed a method that made it possible to identify critical maternal and neonatal health sections of the country and to create a map of the health situation and of the existing health-services capacity in the 112 provinces of Bolivia. The objective of this piece is to describe the method that those experts created and applied.


METHODS
Two indices were created, one for the health situation and the other for the existing health-services capacity. The steps followed in this process were: 1) identifying the variables included in each index, 2) weighting the variables in each index, 3) creating a mathematical formula for each index, 4) preparing a list with the data from each province for the chosen variables and with the percentage for each province for each index, obtained by using the respective formula, 5) setting three continuous-data categories for each index, and 6) defining the taxonomy that was possible by combining the results of the two indices.


RESULTS
Applying this approach, a national map of the maternal health situation and of the existing capacity in each of the 112 Bolivian provinces was developed. This made it possible to choose a small number of provinces where the Ministry of Health and Social Welfare could work with other institutions to carry out joint interventions. The 9 selected provinces have a total of 26 municipalities, which include 17 health districts and which have 29% of the population of the country, 33% of the maternal deaths, and an estimated 35% of the early neonatal deaths.


CONCLUSIONS
Using available information, this method generated a map of the overall maternal health situation in the 112 provinces of Bolivia and made it possible to identify critical geographical areas for health interventions.
Proyecto Salud Materna y Neonatal, Programa Internacional de Educación en Ginecología y Obstetricia de la Universidad Johns Hopkins (JHPIEGO), La Paz, Bolivia.
Marcos Paz
MP
Ballivián
Alberto De la Gálvez
Ade L
Murillo-Camberos
D001838:Bolivia; D002391:Catchment Area, Health / Q000706:statistics & numerical data*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007226:Infant Mortality; D007229:Infant Welfare; D007231:Infant, Newborn; D008377:Maps as Topic; D008427:Maternal Health Services / Q000600:supply & distribution*; D008428:Maternal Mortality; D008429:Maternal Welfare; D020380:Needs Assessment; D011635:Public Health Administration