LESSONS FOR PROGRAM DESIGN FROM THE PMM PROJECTS

The Prevention of Maternal Mortality (PMM) Network designed and tested projects for reducing maternal deaths. The focus was on improving the availability, quality and utilization of emergency obstetric care (Em OC) for women with serious complications. Teams' projects included int erventions in health facilities (to improve skills and services and re duce delays in treatment) and in communities (to address lack of trans port, funds and information concerning obstetric complications) The te ams' results, reported in this volume, offer several lessons for progr am planners. Despite difficult conditions in the project countries, th e teams demonstrated that it is almost always possible to make improve ments in the delivery of EmOC. Their work shows that EmOC can be impro ved not only by concentrating on hospitals and physicians, but also by focusing on peripheral facilities and other qualified staff. The team s' findings regarding utilization of EmOC suggest that more people uti lize services when they know them to be functioning well. Community ef forts, including education and mobilization, have a role to play in im proving utilization once services are in place. Improving EmOC need no t be costly, because in many areas the necessary facilities exist and staff are already in place. (C) 1997 International Federation of Gynec ology and Obstetrics.