Validating indicators of the quality of maternal health care: Final report, Mexico

Despite widespread use, the majority of indicators proposed as measures of the quality of maternal health services have not been sufficiently validated. To help accurately track progress toward national and global maternal health goals, the present study sought to validate and identify a set of maternal health indicators that can be practically applied in facility and population-based surveys. To evaluate the indicators, the study employed a facility-based design. The study was conducted in public/government hospital facilities in Kenya and Mexico. Participants included women aged 15–49 who underwent labor and delivery at participating study facilities and the providers who attended them. Women’s self-report of obstetric and immediate postnatal maternal and newborn care received was compared against a “gold standard” of observations by a trained third-party observer during labor and delivery. This report presents results of the Mexico study

Mujeres migrantes en Tapachula: barreras y facilitadores para el acceso a la salud sexual y reproductiva en 2020—Informe de la investigación

A través de la mirada de mujeres migrantes, organizaciones de la sociedad civil y organismos internacionales, así como de trabajadores de la salud, el estudio muestra las barreras y facilitadores para la atención de la salud sexual y reproductiva de mujeres migrantes en esta ciudad fronteriza del sur de México. --- Through the viewpoints of migrant women, civil society organizations and international agencies, as well as through the views of healthcare workers, this study shows the barriers and enablers to access sexual and reproductive healthcare among migrant women in the southern border frontier Mexico

Mujeres migrantes en Tapachula, Mexico: barreras y facilitadores para el acceso a la salud sexual y reproductiva en 2020—Resumen de la investigación

A través de la mirada de mujeres migrantes, organizaciones de la sociedad civil y organismos internacionales, así como de trabajadores de la salud, el estudio muestra las barreras y facilitadores para la atención de la salud sexual y reproductiva de mujeres migrantes en esta ciudad fronteriza del sur de México. --- Through the viewpoints of migrant women, civil society organizations and international agencies, as well as through the views of healthcare workers, this study shows the barriers and enablers to access sexual and reproductive healthcare among migrant women in the southern border frontier Mexico

Measuring progress in maternal and newborn health care in Mexico: Validating indicators of health system contact and quality of care

Background: The majority of births in Mexico take place in a health facility and are attended by a skilled birth attendant, yet maternal mortality has not declined to anticipated levels. Coverage estimates of skilled attendance and other maternal and newborn interventions often rely on women’s self-report through a population-based survey, the accuracy of which is not well established. Methods: We used a facility-based design to validate women’s report of skilled birth attendance, as well as other key elements of maternal, newborn intrapartum, and immediate postnatal care. Women’s reports of labor and delivery care were collected by exit interview prior to hospital discharge and were compared against direct observation by a trained third party in a Mexican public hospital (n = 597). For each indicator, validity was assessed at the individual level using the area under the receiver operating curve (AUC) and at the population level using the inflation factor (IF). Results: Five of 47 indicators met both validation criteria (AUC \u3e 0.60 and 0.75 \u3c IF \u3c 1.25): urine sample screen, injection or IV medication received during labor, before the birth of the baby (i.e., uterotonic for either induction or augmentation of labor), episiotomy, excessive bleeding, and receipt of blood products. An additional 9 indicators met criteria for the AUC and 18 met criteria for the IF. A skilled attendant indicator had high sensitivity (90.1 %: 95 % CI: 87.1–92.5 %), low specificity (14.0 %: 95 % CI: 5.8–26.7 %) and was suitable for population-level estimation only. Conclusion: Women are able to give valid reports on some aspects of the content of care, although questions regarding the indication for interventions are less likely to be known. Questions that include technical terms or refer to specific time periods tended to have lower response levels. A key aspect of efforts to improve maternal and newborn health requires valid measurement of women’s access to maternal and newborn health interventions and the quality of such services. Additional work on improving measurement of population coverage indicators is warranted

Additional file 5: Table S1. of Measuring progress in maternal and newborn health care in Mexico: validating indicators of health system contact and quality of care

List of Maternal and Newborn Care Indicators Assessed and Reported Prevalence. (DOC 173 kb

Barriers to the use of maternity waiting homes in indigenous regions of Guatemala: A study of users\u27 and community members\u27 perceptions

Maternal mortality among indigenous women in Guatemala is high. To reduce deaths during transport from far-away rural communities to the hospital, maternity waiting homes (MWH) were established near to hospitals where women with high-risk pregnancies await their delivery before being transferred for labour to the hospital. However, the homes are under-utilised. We conducted a qualitative study with 48 stakeholders (MWH users, family members, community leaders, MWH staff, Mayan midwives and health centre and hospital medical staff) in Huehuetenango and Cuilco to identify barriers before, during and after the women’s stay in the homes. The women most in need—indigenous women from remote areas—seemed to have least access to the MWHs. Service users’ lack of knowledge about the existence of the homes, limited provision of culturally appropriate care and a lack of sustainable funding were the most important problems identified. While the strategy of MWHs has the potential to contribute to the prevention of maternal (as well as newborn) deaths in rural Guatemala, they can only function effectively if they are planned and implemented with community involvement and support, through a participatory approach