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Referral and Surveillance Systems

Referral and Surveillance Systems

The TRAction Project seeks to strengthen the network of maternal and child health services in resource-poor settings in the developing world, by focusing on referral systems and surveillance of complications, mortality and morbidity.
 
To achieve this, TRAction is implementing different projects (described in the tabs below) that provide technical assistance in the proper implementation of the network health services in areas of malnutrition, maternal  and neonatal mortality reduction, and evaluating the implementation of these integrated health systems.
In Guatemala, TRAction works in the Western Highlands, a region that is known to have the highest prevalence of malnutrition and diseases, and lack of adequate provision of health services among the poorer, indigenous population that live in rural areas. The main reason for USAID to concentrate all of its projects in this geographical area is to carry out integrated interventions that will synergistically improve the health and nutritional status of the target population groups, mothers of reproductive age and children under five.
In Bangladesh, emergency events, geographic and financial barriers hold substantial influence over the decision to seek care, and act as major deterrents to completion of referrals. Several large scale MNCH initiatives in the country, including efforts by BRAC, Save the Children & the International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), have taken innovative approaches to referral to decrease delay and increase referral compliance. TRAction is assessing the effectiveness of the referral system implemented by Save the Children, comparing it with other models currently operating in Bangladesh.
 
 

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Referral System in Bangladesh

Referral System in Bangladesh

The aim of this study is to explore the effectiveness of several referral systems for maternal, neonatal & child (MNCH) emergencies in Bangladesh. 

Implemented by International Centre for Diarrheal Disease Research (icddr,b).
 
Location: Bangladesh

Case Study: Maternal Mortality Surveillance

Indigenous midwives during a training session in Guatemala
Strengthening Maternal Mortality Surveillance

The MOH seeks assistance to develop a strategic plan in the health area of Alta Verapaz to significantly reduce the maternal mortality as well as risk factors responsible for mortality. Maternal mortality is mainly occurring at the household/community level, but is also high in institutions such as health centers and hospitals when complications are referred to them. In order to respond to the expectations of the MOH, the TRAction team will develop a surveillance system to strengthen maternal mortality and a case study to explore and inform maternal mortality surveillance systems in other geographic areas.

Network of MNCHN Services

In Santo Tomás Milpas Altas, Guatemala, WINGS Family Planning Educator Evelyn registers women to receive the long-term contraceptive methods of their choice, which were predominantly Jadelle implants. © 2015 Anna Zatonow/WINGS Guatemala, Courtesy of Photoshare
Strengthening the Network of MNCHN Services

The current Guatemalan government which took office in 2012, defined as a priority to establish a network of Maternal, Neonatal, Child Health, and Nutrition (MNCHN) services aiming at the prevention and reduction of malnutrition and maternal, infant and child mortality. In order to identify the preventive and clinical packages to be implemented, as well as the system for the organization of health services, the TRAction/USAID project will engage in technical cooperation activities and develop a implementation assessment approach in the Western Highlands of Guatemala.