Back to Search
Start Over
An integrated approach to improve maternal and perinatal outcomes in rural Guatemala: A stepped-wedge cluster randomized trial.
- Source :
-
International Journal of Gynecology & Obstetrics . Oct2020, Vol. 151 Issue 1, p109-116. 8p. - Publication Year :
- 2020
-
Abstract
- <bold>Objective: </bold>To evaluate the impact of an intervention package on maternal and newborn health indicators.<bold>Methods: </bold>A randomized stepped-wedge non-blind trial was conducted across six subdistricts within two districts in Guatemala from January 2014 to January 2017. Data on outcomes were collected on all deliveries in all 33 health centers. The intervention package included distribution of promotional materials encouraging health center delivery; education for traditional birth attendants about the importance of health center delivery; and provider capacity building using simulation training. Main outcomes were number of health center deliveries, maternal morbidity, and perinatal morbidity and mortality.<bold>Results: </bold>Overall, there were 24 412 deliveries. Health center deliveries per 1000 live births showed an overall increase, although after adjustment for secular trends and clustering, the relative risk for the treatment effect was not statistically significant (aRR, 1.04; 95% confidence interval [CI], 0.97-1.11, P=0.242). Although not statistically significant, maternal morbidity (aRR, 0.78; 95% CI, 0.60-1.02; P=0.068) and perinatal morbidity (aRR, 0.84; 95% CI, 0.68-1.05; P=0.133) showed a tendency toward a decrease.<bold>Conclusion: </bold>The present study represents one of the few randomized evaluations of an integrated approach to improve birth outcomes in a low-income setting. ClinicalTrials.gov: NCT0315107. [ABSTRACT FROM AUTHOR]
- Subjects :
- *MIDWIVES
*TREATMENT effectiveness
*MEDICAL centers
*PERINATAL death
*CLUSTER randomized controlled trials
*INFANT health
*MATERNAL health services
*RESEARCH
*RURAL health services
*KEY performance indicators (Management)
*MIDWIFERY
*NURSING specialties
*RESEARCH methodology
*MEDICAL cooperation
*EVALUATION research
*COMPARATIVE studies
*RANDOMIZED controlled trials
*QUALITY assurance
*CLINICAL medicine
*RESEARCH funding
*LABOR (Obstetrics)
*HEALTH promotion
*LONGITUDINAL method
*RURAL population
Subjects
Details
- Language :
- English
- ISSN :
- 00207292
- Volume :
- 151
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- International Journal of Gynecology & Obstetrics
- Publication Type :
- Academic Journal
- Accession number :
- 145646348
- Full Text :
- https://doi.org/10.1002/ijgo.13262