Organizational elements of health service related to a reduction in maternal mortality: The cases of Chile and Colombia

Three differences related to the organization of maternal care services are notable when comparing the cases of Chile and Colombia. The first is the role of geographic (territorial) planning of service availability; second the existence of personnel trained specifically to provide labor and delivery care: and, finally, the level of comprehensiveness of strategies for service delivery. The reduction in maternal mortality is seen as the effect of operationalizing these strategies, among others in both countries. These strategies are compared over a period spanning the pre-reform stage, reform and the following years. The lessons learned from both countries are applicable to effective policy making in other countries from the region. The state is the driver and modulator for these changes, particularly in the reform processes in which there are multiples key actors. (C) 2008 Elsevier Ireland Ltd. All rights reserved.