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

Not Applicable

Completed

• Conditions: Pregnancy
• Interventions: Other: PM/ON integration

• Registration Number: NCT01477541
• Lead Sponsor: Instituto Nacional de Salud Publica, Mexico

Brief Summary

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.

Detailed Description

Not available

Study Timeline

• Study Start: 2007-11
• Primary Completion: 2010-03
• Status Verified: 2011-11
• Study First Submitted: 2011-11-18
• Study First Submitted QC: 2011-11-18
• Last Update Submitted: 2011-11-18
• Study First Posted: 2011-11-22
• Last Update Posted: 2011-11-22

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Not specified
• Target Recruitment: 27

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

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
PM/ON integration arm	PM/ON integration	Health centers where professional midwives or obstetric nurses are integrated into clinic staff and delivering services.

Primary Outcome Measures

Name	Time	Method
Use of evidence-based practices during labor, delivery, and postpartum care	21 months	Will collect data on deliveries ocurring in sites over 21 month period.
volume of prenatal visits, deliveries	21 months	We will Assess overall number of first and follow up prenatal visits and deliveries in intervention and control sites
Use of harmful or unnecessary practices during labor and delivery	21 months	We will assess use of harmful or unnecessary practices during labor and delivery