title: Improving emergency obstetric care in Mozambique: the story of Sofala.
abstract: OBJECTIVE
  The 5-year project in the province of Sofala was designed to improve access, quality and utilization of emergency obstetric care (EmOC) by strengthening rural hospitals and health centers and ultimately the health system's capacity to respond to emergencies more quickly and effectively.
  
  
  METHODS
  Implementation consisted of attention to infrastructure, human resource development, transportation and communication systems, and management. Specific management aspects that were targeted for improvement included: supportive supervision, logistics for supplies, equipment and drugs, record keeping, monitoring and evaluation, and quality improvement techniques such as maternal death audits.
  
  
  RESULTS
  Access to EmOC improved with an increase in the number of fully functional EmOC facilities from 4 to 18. The number of women with obstetric complications who were admitted for treatment in participating facilities tripled, and the proportion of those women dying declined by half.
  
  
  CONCLUSIONS
  Close collaboration and partnership with the provincial health directorate make the sustainability of many results likely while the replication of much of the Sofala model to other provinces is promising for the national strategy to reduce maternal mortality.
authors.affiliation: International Center for AIDS Care and Treatment Program, Maputo, Mozambique.
authors.forename: C
authors.initials: C
authors.lastname: Santos
authors.forename: D
authors.initials: D
authors.lastname: Diante
authors.forename: A
authors.initials: A
authors.lastname: Baptista
authors.forename: E
authors.initials: E
authors.lastname: Matediane
authors.forename: C
authors.initials: C
authors.lastname: Bique
authors.forename: P
authors.initials: P
authors.lastname: Bailey
mesh_terms: D004632:Emergency Medical Services / Q000592:standards*; D005260:Female; D006297:Health Services Accessibility; D006780:Hospitals, Rural / Q000592:standards*; D006801:Humans; D008427:Maternal Health Services / Q000592:standards*; D008428:Maternal Mortality; D009073:Mozambique; D007744:Obstetric Labor Complications / Q000453:epidemiology / Q000517:prevention & control*; D009774:Obstetrics / Q000193:education; D009775:Obstetrics and Gynecology Department, Hospital / Q000458:organization & administration / Q000592:standards; D011247:Pregnancy; D015397:Program Evaluation; D012041:Regional Medical Programs; D017749:Total Quality Management / Q000379:methods*