World Connect works in horizontal relationships with its partners with the understanding that local solutions to local problems always work best. The support provided to Villa Fundacion Hospital draws off of existing institutional capacities, strong relations with the Dominican Ministry of Health and a cadre of changemakers within the hospital and surrounding communities who are committed to improving maternal and neonatal healthcare. To foster sustainable changes, we assist with the formation of quality improvement teams led by local champions.
World Connect equips hospital and referral health clinic staff with the tools, training and resources they need to successfully save and improve the lives of mothers and their newborns. We work with identified changemakers to improve maternal and neonatal services at the facility level. We train physicians, nurses and community health workers; provide appropriate equipment and facility upgrades; and improve hospital systems to promote quality, which will ultimately lead to a reduction of maternal and newborn mortality and morbidity.
The "Humanized Birth Revolution" is demonstrating its effectiveness at the facility level within the Villa Fundacion Hospital. Working with local stakeholders and partners, we are creating a center of excellence for labor and delivery at Villa Fundacion that will be a model for other municipal hospitals within the DR and other Latin American countries supported by World Connect based on the following expected results:
• Skilled and equipped healthcare providers who have received evidenced based training to health utilizing technologically appropriate equipment and are capable of modeling clinical care
• Engaged provincial leaders within community health sector in the DR who have identified areas of need and feel empowered to make necessary changes
• Strengthened relationships between communities, hospitals and health clinics
• Enhanced focus on family-centered care; are capable of providing high quality humanized birth services in a welcoming environment with appropriate referral of high risk cases
• Strengthened data for decision-making based on improved data collection practices and interpretation
communities are armed with knowledge to address health concerns
What will it take for your project to be successful over the next three years? Please address each year separately, if possible.
For the “Humanized Birth Revolution” to be considered a success the project needs to build off the foundation put in place during the current pilot phase. The Villa Fundacion Municipal Hospital will need to move further towards becoming a center of excellence for humanized birth practice. Progress will be incremental focusing in year one on the meeting all of the facility-based criteria for training, equipping and functionality of the Quality Improvement Committee. During year two, the hospital will turn its focus on satellite referral clinics and strengthening relationships with the regional and national Ministry of Health. In year three, the project will need to go scale within the Dominican Republic and serve as a training hub and clearing house for information on humanized birth within the country. Success at the end of year will be judged on the number of additional municipal hospitals working towards meeting the criteria to become centers of excellence for humanized birth. Some of the objectives along this continuum will be implemented simultaneously and adapt to situations on the ground as they develop.
World Connect believes that in order to promote sustainable change and improve maternal and child health, all components of humanized birth described in our expected results need to be present. However, this does not imply that we are responsible for implementing every component; rather we recognize that each one of the components needs to be addressed substantially by local changemakers. For the “Humanized Birth Revolution” to be successful we believe it must integrate a component of constructive accountability and encourage local ownership and oversight by clients and other members of the healthcare team who are associated with the delivery of care within a local health system. Building constructive accountability into health delivery programs is enhanced through the integration of community members into the management of health services. In order for the continuum of maternal, neonatal and childcare to be effectively provided and save lives, providers need to be well trained, available, motivated, and equipped with the necessary tools to provide standard care, address an emergency and refer appropriately.
What would prevent your project from being a success?
Working within an existing health system presents many opportunities, but also many challenges that must be addressed. Relationships must be based on respect and trust. We recognize that the “Humanized Birth Revolution” will only succeed with local support at the municipal, provincial and national level. A decrease of local buy-in at any one of the aforementioned levels could prevent the project from being successful. It is also essential to have community buy-in, when community involvement does not occur the project is missing a key asset which can be catalyzed to address obstacles and resolve problems. Also, a lack of support from the Dominican Government, particularly the Ministry of Health, would not allow the project to scale in the way it was designed.