Lay Midwives: On the Front Lines of the Fight Against Maternal Mortality in Rural Guatemala

Juarez, Michel; Austad, Kirsten; Rohloff, Peter

doi:10.4269/ajtmh.18-0518

Cited by 6 publications

(4 citation statements)

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“…Consequently, successful outcomes have been achieved in many healthcare services through nurse navigation programs (Carter et al., 2018; McKenney et al., 2018; McMurray & Cooper, 2017; Ramirez et al., 2020). Because of these outcomes, nurse navigation programs have been recommended as part of public health services during the postpartum period when patients require the provision of preventive and holistic healthcare (Austad et al., 2017; Carty et al., 2018; Juarez et al., 2019; B. Martinez et al., 2018; Torke et al., 2016; Yee et al., 2017). Public health nurses have important responsibilities to provide comprehensive nursing care that addresses the needs of mothers, newborns, and the family and ensure successful implementation of the program (Cooklin et al., 2015; Egelioğlu Cetişli et al., 2020; Stuebe et al., 2018; Valla et al., 2022).…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, successful outcomes have been achieved in many healthcare services through nurse navigation programs (Carter et al, 2018;McKenney et al, 2018;McMurray & Cooper, 2017;Ramirez et al, 2020). Because of these outcomes, nurse navigation programs have been recommended as part of public health services during the postpartum period when patients require the provision of preventive and holistic healthcare (Austad et al, 2017;Carty et al, 2018;Juarez et al, 2019;B. Martinez et al, 2018;Torke et al, 2016;Yee et al, 2017).…”

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confidence: 99%

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Evaluation of the effect of a nurse navigation program developed for postpartum mothers on maternal health: A randomized controlled study

Öztoprak

Koç

Erkaya

2023

Public Health Nursing

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ObjectiveThis study aimed to determine the effects of a nurse navigation program on the capability for self‐care, quality of life, risk of anxiety and depression, and severity of the physical symptoms of postpartum mothers.MethodsThis prospective, parallel‐group, randomized controlled study included 64 primiparous pregnant women (32 women each in the intervention and control groups) at ≥36 gestational weeks admitted to the pregnancy outpatient clinic of a public hospital in Turkey. The intervention group received navigation program‐based nursing care comprising three home visits, four phone calls, and five text messages aside from the standard hospital care during delivery and the postpartum period. Meanwhile, the control group received only the standard hospital care during delivery and the postpartum period. Data were collected using a sociodemographic data form, the Self‐Care Power Scale, the Maternal Postpartum Quality of Life Instrument (MPQoL‐I), the Postpartum Specific Anxiety Scale (PSAS), the Edinburgh Postnatal Depression Scale (EPDS), and the Postpartum Physical Symptom Severity Scale.ResultsMean scores for the capability for self‐care and quality of life were higher, while those for the risk of depression and anxiety were lower for the intervention group than the control group (p < .05).ConclusionsNavigation program‐based care provided to primiparous mothers improved maternal health.

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

Evaluation of the effect of a nurse navigation program developed for postpartum mothers on maternal health: A randomized controlled study

Öztoprak

Koç

Erkaya

2023

Public Health Nursing

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“…Among the Mayan population, an estimated 39% of the national population, there are 21 unique languages spoken ( 18 ). At health facilities, it can be difficult to find bilingual staff or interpreters ( 19 ). Not only do language barriers cause feelings of alienation and negatively affect patient-provider relations, but serious miscommunications can occur that directly affect treatment adherence, informed consent, and diagnostic accuracy ( 13 , 14 ).…”

Section: Resultsmentioning

confidence: 99%

Bottlenecks and barriers to effective coverage of early childhood health and development interventions in Guatemala: A scoping review

Marra

Espinosa

2020

Revista Panamericana De Salud Pública

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Objectives. To identify bottlenecks and barriers to effective coverage by Early Childhood Health and Development (ECHD) interventions in Guatemala. Methods. A scoping review of more than 100 peer-reviewed articles, grey literature, and other academic publications was conducted. Articles published from 2005-2019 were considered. Results were analyzed using the Tanahashi model of effective coverage that categorizes coverage by five domains: availability, accessibility, acceptability, contact, and effective coverage. Results. A total of 103 articles were identified, addressing 337 bottlenecks and barriers to effective coverage by ECHD interventions in Guatemala. Most occurred along the acceptability dimension (35.9%). The findings revealed four opportunity spaces: (i) strong political interest and commitment (opportunity for leadership); (ii) vibrant community health networks (opportunity for leverage); (iii) availability of promising evidence-based projects and interventions (opportunity for scale-up); and (iv) strong agency presence (opportunity for collaboration). Conclusions. Most bottlenecks and barriers to ECHD interventions in Guatemala occur around acceptability, followed by accessibility and availability. There is considerable potential for national leadership, leverage, scale-up, and collaboration of ongoing efforts in the country. These results may be used to inform future research and policymaking. The Tanahashi approach is an effective lens of analysis that can be applied to other countries, geographic areas, and contexts in future studies.

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“…Attendance at these sessions is required in order to receive a license to practice. Other than these monthly education sessions, however, there is limited formal support—such as assistance with triage—from public health posts for midwives 8 9. Within this practice environment, mobile health (mHealth) technology may be able to improve the continuum of care, as it may provide midwives with decision support to assess complications and make referral decisions and to formalise their interactions with other health systems staff 10 11…”

Section: Introductionmentioning

confidence: 99%

Working with lay midwives to improve the detection of neonatal complications in rural Guatemala

et al. 2020

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BackgroundGlobally most neonatal deaths occur within the first week of life and in low-income and middle-income countries. Strengthening health system linkages for frontline providers—such as lay midwives providing home-based obstetrical care—may improve neonatal outcomes in these settings. Here, we conducted a quality improvement study to increase the detection of neonatal complications by lay midwives in rural Guatemala, thereby increasing referrals to a higher level of care.MethodsA quality improvement team in Guatemala reviewed drivers of neonatal health services provided by lay midwives. Improvement interventions included training on neonatal warning signs, optimised mobile health technology to standardise assessments and financial incentives for providers. The primary quality outcome was the rate of neonatal referral to a higher level of care.ResultsFrom September 2017 to September 2018, participating midwives attended 869 home deliveries and referred 80 neonates to a higher level of care. A proportion control chart, using the preintervention period from January to September 2017 as the baseline, showed an increase in the referral rate of all births from 1.5% to 9.9%. Special cause was obtained in January 2018 and sustained except for May 2018. The proportion of neonates receiving assessments by midwives in the first week of life increased to >90%. A trend toward an increasing number of days between neonatal deaths did not attain special cause.ConclusionsStructured improvement interventions, including mobile health decision support and financial incentives, significantly increased the detection of neonatal complications and referral of neonates to higher levels of care by lay midwives operating in rural home-based settings in Guatemala. The results show the value of improving the integration of lay midwives and other first responders into neonatal systems of care in low-resource settings.

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Lay Midwives: On the Front Lines of the Fight Against Maternal Mortality in Rural Guatemala

Cited by 6 publications

References 0 publications

Evaluation of the effect of a nurse navigation program developed for postpartum mothers on maternal health: A randomized controlled study

Evaluation of the effect of a nurse navigation program developed for postpartum mothers on maternal health: A randomized controlled study

Bottlenecks and barriers to effective coverage of early childhood health and development interventions in Guatemala: A scoping review

Working with lay midwives to improve the detection of neonatal complications in rural Guatemala

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