Evidence map›Paper›PMID 34852795›Full record

ArticleBMC pediatrics2021

Tackling equitable coverage and quality of care for neonates in hospitals: a pre-post assessment on asphyxia interventions in Mesoamerica.

Aruna M Kamath, Maximilian G Thom, Casey K Johanns, Katie Panhorst Harris, Karla Schwarzbauer, José C Ochoa, Paola Zuniga-Brenes, Diego Rios-Zertuche, Ali H Mokdad, Bernardo Hernandez

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pediatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 74% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Aruna M KamathInstitute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA. akamath@uw.edu.
Maximilian G ThomInstitute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA.
Casey K JohannsInstitute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA.
Katie Panhorst HarrisInstitute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA.
Karla SchwarzbauerInter-American Development Bank, Washington, DC, USA.
José C OchoaInter-American Development Bank, Washington, DC, USA.
Paola Zuniga-BrenesInter-American Development Bank, San José, Costa Rica.
Diego Rios-ZertucheInter-American Development Bank, Washington, DC, USA.
Ali H MokdadInstitute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA.
Bernardo HernandezInstitute for Health Metrics and Evaluation, University of Washington, 3980 15th Ave NE, Seattle, WA, 98195, USA.
University of Washington · USInter-American Development Bank · USInstitute for Health Metrics and Evaluation · US

Funding

Anesthesiology & Perioperative Medicine Training GrantT32GM086270 · NIGMS · UNIVERSITY OF WASHINGTON · PI Tonya M Palermo · 2009 to 2026
$4.3M
NIGMS NIH HHS T32 GM086270
6 · The paper itself

Abstract

backgroundIntrapartum-related hypoxic events, or birth asphyxia, causes one-fourth of neonatal deaths globally and in Mesoamerica. Multidimensional care for asphyxia must be implemented to ensure timely and effective care of newborns. Salud Mesoamérica Initiative (SMI) is a performance-based program seeking to improve maternal and child health for low-income areas of Central America. Our objective was to assess the impact of SMI on neonatal asphyxia care in health centers and hospitals in the region.

methodsA pre-post design. Two hundred forty-eight cases of asphyxia were randomly selected from medical records at baseline (2011-2013) and at second-phase follow-up (2017-2018) in Mexico (state of Chiapas), Honduras, Nicaragua, and Guatemala as part of the SMI Initiative evaluation. A facility survey was conducted to assess quality of health care and the management of asphyxia. The primary outcome was coverage of multidimensional care for the management of asphyxia, consisting of a skilled provider presence at birth, immediate assessment, initial stabilization, and appropriate resuscitation measures of the newborn. Data were analyzed using multivariable logistic regression.

resultsManagement of asphyxia improved significantly after SMI. Proper care of asphyxia in intervention areas was better (OR = 2.4; 95% CI = 1.3-4.6) compared to baseline. Additionally, multidimensional care was significantly higher in Honduras (OR = 4.0; 95% CI = 1.4-12.0) than in Mexico. Of the four multidimensional care components, resuscitation showed the greatest progress by follow-up (65.7%) compared to baseline (38.7%).

conclusionSMI improved the care for neonatal asphyxia management across all levels of health care in all countries. Our findings show that proper training and adequate supplies can improve health outcomes in low-income communities. SMI provides a model for improving health care in other settings.

Indexed as

AsphyxiaAsphyxia NeonatorumChildDelivery of Health CareHealth FacilitiesHospitalsHumansInfant, NewbornQuality of Health CareBirth asphyxiaCentral AmericaGuatemalaHondurasIntra-partum related hypoxiaMexicoNeonateNewbornNicaraguaQuality of care

Identifiers

PMID34852795
PMCPMC8638427
OpenAlexW3216737816

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.