Ramos, L. C. (2013). Enhancement of maternal care program: The case of Anda, Bohol (Unpublished master's thesis). Graduate School of Public and Development Management, Development Academy of the Philippines.

Graduate School of Public and Development Management Health Systems and Development Batch 3 Thesis (MPM-HSD)--Development Academy of the Philippines.

To reach the national target for MDG 5 of reducing maternal mortality rate by 75% from 1990 to 2015, the Department of Health launched the Maternal, Neonatal and Child Health and Nutrition strategy. This strategy focuses on interventions with the greatest impact on reproductive health including facility-based births attended by skilled health professionals. To achieve this in the municipal level, DOH partnered with LGUs in enhancing rural birthing facilities and ensure that all women have access to safe, efficient and quality maternal health care. This action plan and project worked on developing a birthing facility service delivery system in Anda, Bohol, explored ways to improve the quality of service delivery and identified measures to sustain the quality service. A qualitative and quantitative descriptive study was done where baseline data on facility practices were collected through direct observation, interview of staff and engaging in FGDs with all service providers. Problems in the health system were identified such as inadequate number of midwives with no recent training, non-adherence to DOH guidelines on maternal and neonatal care and frequent inability of supplies and medicines. It was also observed that the facility lacked data recording and referral systems and, a municipal ordinance on facility-based delivery was adopted but not strictly enforced. Interventions were done through organization management to improve the quality of the birthing facility service delivery. measures such as allocation of budget for augmentation of workforce, lectures on guidelines on maternal and neonatal care and recommendations on the creation of a supplies procurement system were done. Data recording and referral systems were also introduced, and ordinance reinforcement was pursued through IEC. As an indirect measurement of he sustainability of the quality of birthing facility service delivery, a systematic random sampling of respondents who were asked to accomplish a client satisfaction survey was done. Majority of the thirty-two selected clients, or mothers who have given birth in the Anda birthing facility, gave the birthing facility service a very good rating. The midwives were also made to accomplish a self-evaluation survey to further engage the service providers in health service quality improvement. Five of the eight midwives gave the patient care they offer patients a very good rating. A majority also rated the physician's care as very good. Effective management of the facility's elements and resources is paramount in developing a birthing service delivery system. Improving the quality of birthing facility service entails leveraging all resource available in ways that achieve better health outcomes through provision of safe and effective health care.