Assessing the continuum of care for maternal health in Mexico, 1994–2018

Abstract

Objective To describe the temporal and geographical patterns of the continuum of maternal health care in Mexico, as well as the sociodemographic characteristics that affect the likelihood of receiving this care. Methods We conducted a pooled cross-sectional analysis using the 1997, 2009, 2014 and 2018 waves of the National Survey of Demographic Dynamics, collating sociodemographic and obstetric characteristics of 93 745 women aged 12–54 years at last delivery. We defined eight variables along the antenatal–postnatal continuum, both independently and conditionally. We used a pooled fixed-effects multivariable logistic model to determine the likelihood of receiving the continuum of care for various properties. We also mapped the quintiles of adjusted state-level absolute change in continuum of care coverage during 1994–2018. Findings We observed large absolute increases in the proportion of women receiving timely antenatal and postnatal care (from 48.9% to 88.2% and from 39.1% to 68.7%, respectively). In our conditional analysis, we found that the proportion of women receiving adequate antenatal care doubled over this period. We showed that having social security and a higher level of education is positively associated with receiving the continuum of care. We observed the largest relative increases in continuum of care coverage in Chiapas (181.5%) and Durango (160.6%), assigned human development index categories of low and medium, respectively. Conclusion Despite significant progress in coverage of the continuum of maternal health care, disparities remain. While ensuring progress towards achievement of the health-related sustainable development goal, government intervention must also target underserved populations.

Continuum of care for maternal, newborn, and child health in 17 sub-Saharan African countries

“…Consistent with the findings of a related study conducted in Mexico [31], we found a statistically significant association between health insurance coverage and MNCH CoC. Women who had health insurance coverage were 1.64 times more likely to complete all 11 MNCH care interventions along with the CoC as compared to their colleagues who had no health insurance coverage.…”

The Continuum of Care in Cross-Border Health Travel

“…This may suggest that there may be other mitigating factors at play in their self-report scores (such as their current social, economic, or emotional situation). In the Servan-Mori, et al (2021) analysis, the authors, in their sample, found an increase in national continuum of care coverage by around 30% from 1994-1997 to 2015-2018, regardless of health insurance status. A similar increase or decrease in the MMP sample (of their perceived continuum of care status) could also be occurring leading to slightly different scores over time (e.g., the PPACA was passed in 2010 in the U.S. which could have impacted the immigrants health scores over the latter half of the data collected).…”

“…The previous authors (Servan -Mori, et al, 2021) suggested that having continuum of care protocols could lead to more opportunities for a healthy patients (better health outcomes-including reduced mortality rates for both mother and baby), help to ensure that services are delivered in a standardized & integrated way, assist in avoiding inefficiencies, and control for healthcare costs (usually associated with waste or errors). In a migrant population which lacks these linkages or integrations, the expectation would be that one or more of these measures would be negatively affected.…”

Estudio Descriptivo: Cumplimiento del estándar de estimación de la edad gestacional en la atención prenatal en un hospital general en Ecuador

“…Luego de la autorización de la Dirección del Hospital General de Machala, se levantó los datos de las historias clínicas de las pacientes, que constan en el sistema médico de la Institución (AS400), en un formulario de recolección de la información elaborado por los autores. Se obtuvieron datos de las siguientes variables : edad; paridad; edad gestación/ edad menstrual: es el tiempo transcurrido desde el primer día del último período menstrual (FUM); fecha de ultima menstruación confiable: es la fecha del primer día de última menstruación que en que la paciente recuerda con precisión la fecha, tiene ciclos regulares, y no ha usado anticonceptivos en los últimos 3 meses; datación gestacional ecográfica temprana: es la estimación de la edad gestacional por ecografía realizada antes de la semana 24 de gestación según la OMS, 23 semanas de gestación según J Obstet Gynaecol Can, 22 semanas de gestación según la ACOG, 20 semanas de gestación según Hospital Materno Infantil Ramón Sardá [7] [8] [9], se tomó en consideración la recomendación de la OMS ; embarazo con datación de edad gestacional segura/confiable : mujeres embarazadas en las que se realizó un examen de ultrasonido a las 24 + 0 semanas de gestación o menos, confirmando o revisando la fecha de la última menstruación; se consideró una fecha de la última menstruación confiable cuando existió una diferencia de menos de 7 días, con la ecografía temprana. Posteriormente se tabuló los datos, los resultados se presentan como frecuencias y porcentajes por medio de tablas y gráficos.…”