Tackling equitable coverage and quality of care for neonates in hospitals: a pre-post assessment on asphyxia interventions in Mesoamerica

Abstract Background Intrapartum-related hypoxic events, or birth asphyxia, causes one-fourth of neonatal deaths globally and in Mesoamerica. Multidimensional care for asphyxia must be implemented to ensure timely and effective care of newborns. Salud Mesoamérica Initiative (SMI) is a performance-bas...

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Autores principales:	Aruna M. Kamath, Maximilian G. Thom, Casey K. Johanns, Katie Panhorst Harris, Karla Schwarzbauer, José C. Ochoa, Paola Zuniga-Brenes, Diego Rios-Zertuche, Ali H. Mokdad, Bernardo Hernandez
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Birth asphyxia Intra-partum related hypoxia Neonate Newborn Quality of care Central America Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/9a5709657b17462d8c31a76bf32723da
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spelling	oai:doaj.org-article:9a5709657b17462d8c31a76bf32723da2021-12-05T12:21:19ZTackling equitable coverage and quality of care for neonates in hospitals: a pre-post assessment on asphyxia interventions in Mesoamerica10.1186/s12887-021-02999-01471-2431https://doaj.org/article/9a5709657b17462d8c31a76bf32723da2021-12-01T00:00:00Zhttps://doi.org/10.1186/s12887-021-02999-0https://doaj.org/toc/1471-2431Abstract Background Intrapartum-related hypoxic events, or birth asphyxia, causes one-fourth of neonatal deaths globally and in Mesoamerica. Multidimensional care for asphyxia must be implemented to ensure timely and effective care of newborns. Salud Mesoamérica Initiative (SMI) is a performance-based program seeking to improve maternal and child health for low-income areas of Central America. Our objective was to assess the impact of SMI on neonatal asphyxia care in health centers and hospitals in the region. Methods A pre-post design. Two hundred forty-eight cases of asphyxia were randomly selected from medical records at baseline (2011–2013) and at second-phase follow-up (2017–2018) in Mexico (state of Chiapas), Honduras, Nicaragua, and Guatemala as part of the SMI Initiative evaluation. A facility survey was conducted to assess quality of health care and the management of asphyxia. The primary outcome was coverage of multidimensional care for the management of asphyxia, consisting of a skilled provider presence at birth, immediate assessment, initial stabilization, and appropriate resuscitation measures of the newborn. Data were analyzed using multivariable logistic regression. Results Management of asphyxia improved significantly after SMI. Proper care of asphyxia in intervention areas was better (OR = 2.4; 95% CI = 1.3–4.6) compared to baseline. Additionally, multidimensional care was significantly higher in Honduras (OR = 4.0; 95% CI = 1.4–12.0) than in Mexico. Of the four multidimensional care components, resuscitation showed the greatest progress by follow-up (65.7%) compared to baseline (38.7%). Conclusion SMI improved the care for neonatal asphyxia management across all levels of health care in all countries. Our findings show that proper training and adequate supplies can improve health outcomes in low-income communities. SMI provides a model for improving health care in other settings.Aruna M. KamathMaximilian G. ThomCasey K. JohannsKatie Panhorst HarrisKarla SchwarzbauerJosé C. OchoaPaola Zuniga-BrenesDiego Rios-ZertucheAli H. MokdadBernardo HernandezBMCarticleBirth asphyxiaIntra-partum related hypoxiaNeonateNewbornQuality of careCentral AmericaPediatricsRJ1-570ENBMC Pediatrics, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Birth asphyxia Intra-partum related hypoxia Neonate Newborn Quality of care Central America Pediatrics RJ1-570
spellingShingle	Birth asphyxia Intra-partum related hypoxia Neonate Newborn Quality of care Central America Pediatrics RJ1-570 Aruna M. Kamath Maximilian G. Thom Casey K. Johanns Katie Panhorst Harris Karla Schwarzbauer José C. Ochoa Paola Zuniga-Brenes Diego Rios-Zertuche Ali H. Mokdad Bernardo Hernandez Tackling equitable coverage and quality of care for neonates in hospitals: a pre-post assessment on asphyxia interventions in Mesoamerica
description	Abstract Background Intrapartum-related hypoxic events, or birth asphyxia, causes one-fourth of neonatal deaths globally and in Mesoamerica. Multidimensional care for asphyxia must be implemented to ensure timely and effective care of newborns. Salud Mesoamérica Initiative (SMI) is a performance-based program seeking to improve maternal and child health for low-income areas of Central America. Our objective was to assess the impact of SMI on neonatal asphyxia care in health centers and hospitals in the region. Methods A pre-post design. Two hundred forty-eight cases of asphyxia were randomly selected from medical records at baseline (2011–2013) and at second-phase follow-up (2017–2018) in Mexico (state of Chiapas), Honduras, Nicaragua, and Guatemala as part of the SMI Initiative evaluation. A facility survey was conducted to assess quality of health care and the management of asphyxia. The primary outcome was coverage of multidimensional care for the management of asphyxia, consisting of a skilled provider presence at birth, immediate assessment, initial stabilization, and appropriate resuscitation measures of the newborn. Data were analyzed using multivariable logistic regression. Results Management of asphyxia improved significantly after SMI. Proper care of asphyxia in intervention areas was better (OR = 2.4; 95% CI = 1.3–4.6) compared to baseline. Additionally, multidimensional care was significantly higher in Honduras (OR = 4.0; 95% CI = 1.4–12.0) than in Mexico. Of the four multidimensional care components, resuscitation showed the greatest progress by follow-up (65.7%) compared to baseline (38.7%). Conclusion SMI improved the care for neonatal asphyxia management across all levels of health care in all countries. Our findings show that proper training and adequate supplies can improve health outcomes in low-income communities. SMI provides a model for improving health care in other settings.
format	article
author	Aruna M. Kamath Maximilian G. Thom Casey K. Johanns Katie Panhorst Harris Karla Schwarzbauer José C. Ochoa Paola Zuniga-Brenes Diego Rios-Zertuche Ali H. Mokdad Bernardo Hernandez
author_facet	Aruna M. Kamath Maximilian G. Thom Casey K. Johanns Katie Panhorst Harris Karla Schwarzbauer José C. Ochoa Paola Zuniga-Brenes Diego Rios-Zertuche Ali H. Mokdad Bernardo Hernandez
author_sort	Aruna M. Kamath
title	Tackling equitable coverage and quality of care for neonates in hospitals: a pre-post assessment on asphyxia interventions in Mesoamerica
title_short	Tackling equitable coverage and quality of care for neonates in hospitals: a pre-post assessment on asphyxia interventions in Mesoamerica
title_full	Tackling equitable coverage and quality of care for neonates in hospitals: a pre-post assessment on asphyxia interventions in Mesoamerica
title_fullStr	Tackling equitable coverage and quality of care for neonates in hospitals: a pre-post assessment on asphyxia interventions in Mesoamerica
title_full_unstemmed	Tackling equitable coverage and quality of care for neonates in hospitals: a pre-post assessment on asphyxia interventions in Mesoamerica
title_sort	tackling equitable coverage and quality of care for neonates in hospitals: a pre-post assessment on asphyxia interventions in mesoamerica
publisher	BMC
publishDate	2021
url	https://doaj.org/article/9a5709657b17462d8c31a76bf32723da
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Tackling equitable coverage and quality of care for neonates in hospitals: a pre-post assessment on asphyxia interventions in Mesoamerica

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