Future Generations Peru Concludes a Four-Year Child Survival Project in Cusco

Lima, Peru:  A four-year child survival project of Future Generations Peru, funded by the Child Survival and Health Grants Program of the United States Agency for International Development, achieved significant improvements in 21 key maternal and child health indictors. The number of maternal deaths declined by 75% in the project area, and chronic child malnutrition declined by 9%. The program, designed for sustainability, introduced strategies and capacity-building to strengthen the government primary health care system and link it to communities, trained community health promoters, and local municipalities.

The southern Andes of Peru, Department of Cusco has a high proportion of indigenous Quechua-speaking communities and high levels of maternal and infant mortality and chronic child malnutrition. Public health resources and clinics were available, but did not effectively reach communities. Many health problems were due to inadequate hygiene, health, and nutrition practices in the home.

In response, Future Generations Peru began program Nexos (translated as "linkages"), which was implemented from 2005 to 2009 in 250 rural communities with 119,000 inhabitants through 28 government primary care facilities and 17 district governments. Nexos effectively strengthened the government’s primary health care services by linking them with other public and private institutions and most importantly with mothers and families.

Household surveys (each of 600 mothers and children under age two years) provided evidence of the decrease in chronic malnutrition from 38.4% to 29.8% as well as the decline in underweight from 17.6% to 12% as major project outcomes.

Maternal health also had notable improvements--a 75% decline in maternal deaths-- related to increases in prenatal visits and professional birth attendance. A major contributing factor was a new strategy introduced by the project to promote community involvement in evacuating obstetrical emergencies to the nearest health facility.   

Neonatal health was also improved through the project through increases in early initiation of breastfeeding and from improved practices in drying and warming of the child at birth to avoid deaths due to hypothermia.

In addition, the municipal governments contributed US$4.0 million directly and through a participatory budgeting process to support health activities, hire additional health staff, and invest in health infrastructure based on Community Work Plans.

A range of strategies and methodologies were implemented through the project in order to achieve these results. One successful approach was to further elaborate, define, and develop tools for a Ministry of Health strategy called “sectorization,” which organizes outreach from health services into communities. All partners in primary health, including health staff, local governments, volunteer Community Health Agents, and community leaders, not only learned new technical skills, but learned to work together and leverage their resources to promote health in the home and increase confidence in using the primary care clinics.

The improved process of “sectorization” was so well received that it is under consideration to be made official policy of the Cusco Regional Health Department.

For more details and a copy of the final report, please contact, Laura Altobelli, Country Director of Future Generations Peru, by emailing, laura@future.org or calling our Peru office at 511-436-9619.