The effect of a new maternity unit on maternal outcomes in rural Haiti: an interrupted time series study
Abstract Background In Haiti where there are high rates of maternal and neonatal mortality, efforts to reduce mortality and improve maternal newborn child health (MNCH) must be tracked and monitored to measure their success. At a rural Haitian hospital, local surveillance efforts allowed for the cap...
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| Format: | Article |
| Language: | English |
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BMC
2021-09-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-021-04062-3 |
| _version_ | 1818731942958333952 |
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| author | Tonya MacDonald Olès Dorcely Joycelyne E. Ewusie Elizabeth K. Darling Sandra Moll Lawrence Mbuagbaw |
| author_facet | Tonya MacDonald Olès Dorcely Joycelyne E. Ewusie Elizabeth K. Darling Sandra Moll Lawrence Mbuagbaw |
| author_sort | Tonya MacDonald |
| collection | DOAJ |
| description | Abstract Background In Haiti where there are high rates of maternal and neonatal mortality, efforts to reduce mortality and improve maternal newborn child health (MNCH) must be tracked and monitored to measure their success. At a rural Haitian hospital, local surveillance efforts allowed for the capture of MNCH indicators. In March 2018, a new stand-alone maternity unit was opened, with increased staff, personnel, and physical space. We aimed to determine if the new maternity unit brought about improvements in maternal and neonatal outcomes. Methods We conducted an interrupted time series analysis using data collected between July 2016 and October 2019 including 20 months before the opening of the maternity unit and 20 months after. We examined maternal-neonatal outcomes such as physiological (vaginal) births, caesarean birth, postpartum hemorrhage (PPH), maternal deaths, stillbirths and undesirable outcomes (eclampsia, PPH, perineal laceration, postpartum infection, maternal death or stillbirth). Results Immediately after the opening of the new maternity, the number of physiological births decreased by 7.0% (β = − 0.070; 95% CI: − 0.110 to − 0.029; p = 0.001) and there was an increase of 6.7% in caesarean births (β = 0.067; 95% CI: 0.026 to 0.107; p = 0.002). For all undesirable outcomes, preintervention there was an increasing trend of 1.8% (β = 0.018; 95% CI: 0.013 to 0.024; p < 0.001), an immediate 14.4% decrease after the intervention (β = − 0.144; 95% CI: − 0.255 to − 0.033; p = 0.012), and a decreasing trend of 1.8% through the postintervention period (β = − 0.018; 95% CI: − 0.026 to − 0.009; p < 0.001). No other significant level or trend changes were noted. Conclusions The new maternity unit led to an upward trend in caesarean births yet an overall reduction in all undesirable maternal and neonatal outcomes. The new maternity unit at this rural Haitian hospital positively impacted and improved maternal and neonatal outcomes. |
| first_indexed | 2024-12-17T23:25:42Z |
| format | Article |
| id | doaj.art-e9c56e9980e84317ac3019cea46593cd |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-17T23:25:42Z |
| publishDate | 2021-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-e9c56e9980e84317ac3019cea46593cd2022-12-21T21:28:46ZengBMCBMC Pregnancy and Childbirth1471-23932021-09-0121111110.1186/s12884-021-04062-3The effect of a new maternity unit on maternal outcomes in rural Haiti: an interrupted time series studyTonya MacDonald0Olès Dorcely1Joycelyne E. Ewusie2Elizabeth K. Darling3Sandra Moll4Lawrence Mbuagbaw5Department of Health Research Methods, Evidence and Impact, McMaster University, Health Sciences CentreCentre Médical BéracaDepartment of Health Research Methods, Evidence and Impact, McMaster University, Health Sciences CentreDepartment of Health Research Methods, Evidence and Impact, McMaster University, Health Sciences CentreSchool of Rehabilitation Science, McMaster UniversityDepartment of Health Research Methods, Evidence and Impact, McMaster University, Health Sciences CentreAbstract Background In Haiti where there are high rates of maternal and neonatal mortality, efforts to reduce mortality and improve maternal newborn child health (MNCH) must be tracked and monitored to measure their success. At a rural Haitian hospital, local surveillance efforts allowed for the capture of MNCH indicators. In March 2018, a new stand-alone maternity unit was opened, with increased staff, personnel, and physical space. We aimed to determine if the new maternity unit brought about improvements in maternal and neonatal outcomes. Methods We conducted an interrupted time series analysis using data collected between July 2016 and October 2019 including 20 months before the opening of the maternity unit and 20 months after. We examined maternal-neonatal outcomes such as physiological (vaginal) births, caesarean birth, postpartum hemorrhage (PPH), maternal deaths, stillbirths and undesirable outcomes (eclampsia, PPH, perineal laceration, postpartum infection, maternal death or stillbirth). Results Immediately after the opening of the new maternity, the number of physiological births decreased by 7.0% (β = − 0.070; 95% CI: − 0.110 to − 0.029; p = 0.001) and there was an increase of 6.7% in caesarean births (β = 0.067; 95% CI: 0.026 to 0.107; p = 0.002). For all undesirable outcomes, preintervention there was an increasing trend of 1.8% (β = 0.018; 95% CI: 0.013 to 0.024; p < 0.001), an immediate 14.4% decrease after the intervention (β = − 0.144; 95% CI: − 0.255 to − 0.033; p = 0.012), and a decreasing trend of 1.8% through the postintervention period (β = − 0.018; 95% CI: − 0.026 to − 0.009; p < 0.001). No other significant level or trend changes were noted. Conclusions The new maternity unit led to an upward trend in caesarean births yet an overall reduction in all undesirable maternal and neonatal outcomes. The new maternity unit at this rural Haitian hospital positively impacted and improved maternal and neonatal outcomes.https://doi.org/10.1186/s12884-021-04062-3Maternal mortalityHaitiInterrupted time seriesUndesirable outcomesCaesarean births |
| spellingShingle | Tonya MacDonald Olès Dorcely Joycelyne E. Ewusie Elizabeth K. Darling Sandra Moll Lawrence Mbuagbaw The effect of a new maternity unit on maternal outcomes in rural Haiti: an interrupted time series study BMC Pregnancy and Childbirth Maternal mortality Haiti Interrupted time series Undesirable outcomes Caesarean births |
| title | The effect of a new maternity unit on maternal outcomes in rural Haiti: an interrupted time series study |
| title_full | The effect of a new maternity unit on maternal outcomes in rural Haiti: an interrupted time series study |
| title_fullStr | The effect of a new maternity unit on maternal outcomes in rural Haiti: an interrupted time series study |
| title_full_unstemmed | The effect of a new maternity unit on maternal outcomes in rural Haiti: an interrupted time series study |
| title_short | The effect of a new maternity unit on maternal outcomes in rural Haiti: an interrupted time series study |
| title_sort | effect of a new maternity unit on maternal outcomes in rural haiti an interrupted time series study |
| topic | Maternal mortality Haiti Interrupted time series Undesirable outcomes Caesarean births |
| url | https://doi.org/10.1186/s12884-021-04062-3 |
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