title: Strengthening emergency obstetric care in Ayacucho, Peru.
abstract: OBJECTIVE
  With support from the Averting Maternal Death and Disability (AMDD) Program, CARE began the FEMME Project in 2000 to increase access and utilization of emergency obstetric care (EmOC) services for the approximately 48,000 pregnant women in the northern provinces of Ayacucho.
  
  
  METHODS
  The project targeted 5 facilities with a comprehensive package of interventions designed to improve capacity to provide quality EmOC services and to promote a human rights approach in health care. Key program activities included improvements in infrastructure, human resources capacity development, development of service standards and protocols, quality improvement activities, and promoting a rights-based approach to health.
  
  
  RESULTS
  By the end of the project, northern Ayacucho had 6 functioning EmOC facilities: 3 comprehensive (including a non-FEMME project facility) and 3 basic. This exceeds the UN minimum recommendation of 5 EmOC facilities per 500,000 population. Other changes in the UN process indicators indicate an increase in quality and utilization of EmOC services. Met need for EmOC increased significantly from 30% in 2000 to a high of 84% in 2004. Case fatality rates declined and the number of maternal deaths in the entire region declined.
  
  
  CONCLUSIONS
  CARE's work in Ayacucho made an impact on policies and programs related to EmOC throughout the region. Within CARE, project experiences have supported maternal health programs particularly in the Latin American/Caribbean region.
authors.affiliation: CARE, Atlanta, GA, USA. mkayongo@care.org
authors.forename: M
authors.initials: M
authors.lastname: Kayongo
authors.forename: E
authors.initials: E
authors.lastname: Esquiche
authors.forename: M R
authors.initials: MR
authors.lastname: Luna
authors.forename: G
authors.initials: G
authors.lastname: Frias
authors.forename: L
authors.initials: L
authors.lastname: Vega-Centeno
authors.forename: P
authors.initials: P
authors.lastname: Bailey
mesh_terms: D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric / Q000592:standards* / Q000639:trends; D003906:Developing Countries; D004630:Emergencies; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008428:Maternal Mortality / Q000639:trends; D008429:Maternal Welfare; D020380:Needs Assessment; D007744:Obstetric Labor Complications / Q000453:epidemiology; D010568:Peru / Q000453:epidemiology; D011247:Pregnancy; D011787:Quality of Health Care