Assessing multidimensional care coverage for pre-eclampsia in the era of universal health coverage : A pre-post evaluation of the Salud Mesoamérica Initiative
© 2020 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics..
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<0.001), basic-level facilities (P<0.001), and higher in Honduras (P=0.001) and Belize (P=0.024) than the reference country of Nicaragua.
CONCLUSION: Multidimensional care for pre-eclampsia management increased across all facility types, countries, and severity of disease. The Salud Mesoamérica Initiative is a promising model for achieving such quality of care interventions in the era of universal health coverage.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:149 |
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| Enthalten in: |
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics - 149(2020), 3 vom: 15. Juni, Seite 318-325 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kamath, Aruna M [VerfasserIn] |
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| Links: |
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| Themen: |
Belize |
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| Anmerkungen: |
Date Completed 16.09.2020 Date Revised 16.09.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1002/ijgo.13131 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM307048918 |
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| 100 | 1 | |a Kamath, Aruna M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Assessing multidimensional care coverage for pre-eclampsia in the era of universal health coverage |b A pre-post evaluation of the Salud Mesoamérica Initiative |
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| 500 | |a Date Revised 16.09.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics. | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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<0.001), basic-level facilities (P<0.001), and higher in Honduras (P=0.001) and Belize (P=0.024) than the reference country of Nicaragua | ||
| 520 | |a CONCLUSION: Multidimensional care for pre-eclampsia management increased across all facility types, countries, and severity of disease. The Salud Mesoamérica Initiative is a promising model for achieving such quality of care interventions in the era of universal health coverage | ||
| 650 | 4 | |a Evaluation Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Belize | |
| 650 | 4 | |a Central America | |
| 650 | 4 | |a Eclampsia | |
| 650 | 4 | |a Honduras | |
| 650 | 4 | |a Maternal health | |
| 650 | 4 | |a Nicaragua | |
| 650 | 4 | |a Pre-eclampsia | |
| 650 | 4 | |a Quality of health care | |
| 700 | 1 | |a Johanns, Casey K |e verfasserin |4 aut | |
| 700 | 1 | |a Thom, Maximillian G |e verfasserin |4 aut | |
| 700 | 1 | |a Cogen, Rebecca M |e verfasserin |4 aut | |
| 700 | 1 | |a Rios-Zertuche, Diego |e verfasserin |4 aut | |
| 700 | 1 | |a Mokdad, Ali H |e verfasserin |4 aut | |
| 700 | 1 | |a Hernández, Bernardo |e verfasserin |4 aut | |
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