Improvement of maternal and newborn health through midwifery

Hoope‐Bender, Petra ten; Bernis, Luc de; Campbell, James; Downe, Soo; Fauveau, Vincent; Fogstad, Helga; Homer, Caroline; Kennedy, Holly Powell; Matthews, Zoë; McFadden, Alison; Renfrew, Mary J; Lerberghe, Wim Van

doi:10.1016/s0140-6736(14)60930-2

Cited by 357 publications

(262 citation statements)

References 31 publications

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“…Optimum midwifery services is among the most effective ways in providing high quality maternal, newborn care and thus in reducing maternal and infant mortality especially in developing countries (Renfrew et al, 2014;ten Hoope-Bender et al, 2014). Some of the key causes for maternal and neonatal deaths like infection, post-partum haemorrhage, eclampsia, birth asphyxia and pre-term birth can be averted through competent nursing and midwifery care (SEARO, International day of the Midwife, 5 May 2012).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of virtual classroom training in improving the knowledge and key maternal neonatal health skills of general nurse midwifery students in Bihar, India: A pre- and post-intervention study

Agrawal

Kumar

Balasubramaniam

et al. 2016

Nurse Education Today

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Section: Introductionmentioning

confidence: 99%

Effectiveness of virtual classroom training in improving the knowledge and key maternal neonatal health skills of general nurse midwifery students in Bihar, India: A pre- and post-intervention study

Agrawal

Kumar

Balasubramaniam

et al. 2016

Nurse Education Today

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“…This study is, to our knowledge, the first report of supportive mHealth technology for low-literate TBAs with little previous exposure to technology in a challenging rural healthcare delivery context, as well as the first report of referral rates by TBAs in indigenous populations, and it adds to the evidence of community-based intervention packages for improving maternal and perinatal outcomes [25, 26] and of mHealth interventions integrated within existing healthcare systems as potential solutions for addressing maternal health in LMICs [13, 27–29]. For example, in a study conducted in rural Pakistan by Jokhio et al [30], training TBAs to recognize maternal and perinatal complications, alongside efforts made to better integrate them into the formal health system, resulted in increased referral rates to facility-care for emergency obstetrical care.…”

Section: Discussionmentioning

confidence: 99%

mHealth intervention to improve the continuum of maternal and perinatal care in rural Guatemala: a pragmatic, randomized controlled feasibility trial

et al. 2018

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Background/objectiveGuatemala’s indigenous Maya population has one of the highest perinatal and maternal mortality rates in Latin America. In this population most births are delivered at home by traditional birth attendants (TBAs), who have limited support and linkages to public hospitals. The goal of this study was to characterize the detection of maternal and perinatal complications and rates of facility-level referral by TBAs, and to evaluate the impact of a mHealth decision support system on these rates.MethodsA pragmatic one-year feasibility trial of an mHealth decisions support system was conducted in rural Maya communities in collaboration with TBAs. TBAs were individually randomized in an unblinded fashion to either early-access or later-access to the mHealth system. TBAs in the early-access arm used the mHealth system throughout the study. TBAs in the later-access arm provided usual care until crossing over uni-directionally to the mHealth system at the study midpoint. The primary study outcome was the monthly rate of referral to facility-level care, adjusted for birth volume.ResultsForty-four TBAs were randomized, 23 to the early-access arm and 21 to the later-access arm. Outcomes were analyzed for 799 pregnancies (early-access 425, later-access 374). Monthly referral rates to facility-level care were significantly higher among the early-access arm (median 33 referrals per 100 births, IQR 22–58) compared to the later-access arm (median 20 per 100, IQR 0–30) (p = 0.03). At the study midpoint, the later-access arm began using the mHealth platform and its referral rates increased (median 34 referrals per 100 births, IQR 5–50) with no significant difference from the early-access arm (p = 0.58). Rates of complications were similar in both arms, except for hypertensive disorders of pregnancy, which were significantly higher among TBAs in the early-access arm (RR 3.3, 95% CI 1.10–9.86).ConclusionsReferral rates were higher when TBAs had access to the mHealth platform. The introduction of mHealth supportive technologies for TBAs is feasible and can improve detection of complications and timely referral to facility-care within challenging healthcare delivery contexts.Trial registrationClinicaltrials.gov NCT02348840.

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“…4, 32, 33 Interprofessional and collaborative model of practice and provision of perinatal health services have the potential to decrease unnecessary interventions while increasing patient safety and engagement in care. 31, 34 However, there are few published studies on collaborative, interprofessional models beyond a few case reports. This small-scale feasibility study contributes valuable information that simultaneous collaborative visits involving a nurse-midwife from the woman's chosen practice and an MFM specialist are logically feasible and improve communication among providers and pregnant women.…”

Section: Discussionmentioning

confidence: 99%

On the same page: a novel interprofessional model of patient-centered perinatal consultation visits

et al. 2016

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OBJECTIVE To plan and implement an interprofessional collaborative care clinic for women in midwifery care needing a consultation with a maternal-fetal medicine specialist. DESIGN A community-engaged design was used to develop a new model of collaborative perinatal consultation which was tested with 50 women. Participant perinatal outcomes and semi-structured interviews with 15 women (analyzed using qualitative descriptive analysis) and clinic providers were used to evaluate the model. RESULT Participant perinatal outcomes following a simultaneous consultation visit involving a nurse-midwife and maternal-fetal medicine specialist were similar to practice and hospital averages. Women's comments on their experience were positive and had the theme “on the same page,” with 6 sub-categories: clarity, communication, collaboration, planning, validation, and ‘above and beyond.’ Providers also were pleased with the model. CONCLUSION A simultaneous consultation involving the woman, a nurse-midwife, and a maternal-fetal medicine specialist improved communication and satisfaction among women and providers.

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Improvement of maternal and newborn health through midwifery

Cited by 357 publications

References 31 publications

Effectiveness of virtual classroom training in improving the knowledge and key maternal neonatal health skills of general nurse midwifery students in Bihar, India: A pre- and post-intervention study

Effectiveness of virtual classroom training in improving the knowledge and key maternal neonatal health skills of general nurse midwifery students in Bihar, India: A pre- and post-intervention study

mHealth intervention to improve the continuum of maternal and perinatal care in rural Guatemala: a pragmatic, randomized controlled feasibility trial

On the same page: a novel interprofessional model of patient-centered perinatal consultation visits

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