Cluster-randomized Trial Measuring Integration of Professional Midwives and Obstetric Nurses in Rural Clinics in Mexico

Secretariat of Health

Status: Completed

Conditions: Pregnancy

Treatments: Other: PM/ON integration

Study type: Interventional

Funder types: Other

Identifiers

NCT01477541

104-6466

Details and patient eligibility

About

Rates and causes of maternal mortality in Mexico have dropped only slightly; thus, reaching the internationally established Millennium Development Milestones (MDM) is still a distant goal. A fundamental part of reducing maternal and infant mortality is ensuring skilled attendance during pregnancy and delivery. This project uses an innovative strategy of integrating professional midwives and licensed obstetric nurses into rural medical centers in the states of Guerrero and Oaxaca, Mexico, to provide prenatal care, delivery services, and puerperium care. The goal of the research is to increase use of best practices in intake, labor, delivery, and puerperium care; decrease the use of unnecessary or harmful care; and improve maternal and neonatal outcomes. We posited that medical centers receiving the intervention would provide better care and have better maternal and neonatal outcomes than those that did not receive the intervention.

Enrollment: 27 patients

Sex

Volunteers: No Healthy Volunteers

Inclusion criteria

• Clinics containing one medical team only (1 doctor and accompanying staff)
• Clinics less than 2 hours away from a referral hospital
• Clinics where at least 25 deliveries took place in the previous year

Exclusion criteria

• Clinics inaccessible by car
• Clinics undergoing remodeling

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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27 participants in 2 patient groups

PM/ON integration arm

Experimental group

Description:

Health centers where professional midwives or obstetric nurses are integrated into clinic staff and delivering services.

Treatment:

Other: PM/ON integration

Control

No Intervention group