Assessing multidimensional care coverage for pre‐eclampsia in the era of universal health coverage: A pre–post evaluation of the Salud Mesoamérica Initiative

Objective To compare a multidimensional care package for pre‐eclampsia/eclampsia in Central American health facilities, before and after implementation of the Salud Mesoamérica Initiative. Methods An evaluation study was conducted at 67 basic‐ and comprehensive‐level health facilities serving the poorest areas in Honduras, Nicaragua, and Belize. Cases of severe pre‐eclampsia or eclampsia were randomly sampled and relevant quality of care data extracted from medical records at baseline (n=111) from January 1, 2011, to March 31, 2013, and at second‐phase follow‐up (n=249) from June 1, 2015, to September 30, 2017. The primary outcome was evidence of the delivery of multidimensional care for the management of pre‐eclampsia/eclampsia. Results The care of 360 women with severe pre‐eclampsia or eclampsia was analyzed. Odds of multidimensional care for pre‐eclampsia management (P=0.271) increased (although not significantly) in the second‐phase follow‐up compared to baseline. Multidimensional care was significantly associated with training (P
Multidimensional care for pre‐eclampsia management increased across all facility types, participating countries, and severity of disease under the Salud Mesoamérica Initiative model in Central America.