Participatory approaches in the co-design of a comprehensive referral system.

Reducing mortality rates for women and children in Third World countries requires improved access to quality, affordable health services. In this article, the authors describe the experiences of the University of Ottawa School of Nursing and its Chinese partner, the Yunnan Provincial Public Health Bureau, in developing and implementing a comprehensive referral system for impoverished rural women and children as part of the Yunnan Maternal and Child Health Project, a six-year dollar 6-million bilateral initiative implemented across 10 counties (population 2.2 million) in Yunnan province, China. Through engaging government officials, health workers, local leaders and village women in dialogue and reflection, Canadian and Chinese partners developed a common understanding about underlying determinants affecting maternal and child health services; explored appropriate intervention options; and developed an innovative comprehensive referral system.