Large numbers of trained community health workers and standardized health systems could reduce the number of maternal, newborn and fetal deaths, according to a study.
The meta-analysis of three studies published today in the Lancet examines the results of 70,000 women in Mozambique, Pakistan and India between 2014 and 2007.
The study aimed to reduce the deaths associated with preeclampsia. Preeclampsia is a condition that causes high blood pressure during pregnancy and after childbirth. Globally, preeclampsia is the second leading cause of maternal death worldwide, with 76,000 maternal deaths and 500,000 fetal and newborn deaths each year. Delays in triage, transportation to health care facilities, and treatment all contribute to the high number of maternal and infant deaths.
The Community Level Interventions for Pre-Eclampsia (CLIP) studies divided women between control and intervention groups. Control groups continued their standard of local care while intervention groups had access to community health workers who could identify, treat, and refer hospital women with high blood pressure, a symptom of preeclampsia. Women were also taught how to spot problems during pregnancy, and health workers had access to an app that could help assess patient risk, as well as blood pressure and blood oxygen machines to assess women in their homes.
Analysis shows that there were fewer maternal deaths, fewer stillbirths, and fewer newborn deaths when there were enough community health workers to provide care. However, if there weren't enough community health workers, there was no impact.
The researchers recommended expanding the community health workforce so that individual women were in contact with care providers at least eight times in each pregnancy, and to improve the standards of health systems.
Professor Peter von Dadelszen of King & # 39; s College London said: "We designed the three CLIP studies in Pakistan, India and Mozambique to feed the results into this analysis. Previously, most efforts were focused on hospital care, and We moved The focus was on caring for pregnant women in their communities, with community health workers taking care of that. Overall, a shortage of community health workers in these communities meant that our intervention did not improve outcomes digital health assisted community health workers who assessed women in their homes could prevent the death of pregnant women and their babies both before and shortly after birth. "
A study of maternal mortality in Mozambique finds serious diagnostic error in a high percentage of deaths
King & # 39; s College London
Community Health Workers Reduce Maternal, Fetal and Newborn Deaths, Study Results, 2020 Aug 20
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