Enhancing Maternal Health Outcomes through the "One Province One Labor Room" Model to Reduce Direct and Indirect Maternal Mortality and Morbidity
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Abstract
BACKGROUND: The “One Province One Labor Room” project was initiated in Surin Province in 2015 and has successfully reduced postpartum hemorrhage mortality. However, most maternal deaths from 2018 to 2022 were attributed to medical conditions involving patients referred from network hospitals. Consequently, the care process was further developed to be more comprehensive and efficient.
OBJECTIVES: To develop and evaluate the outcomes of maternal health care through the “One Province One Labor Room” model in reducing direct and indirect maternal morbidity and mortality.
METHODS: This study employed Participatory Action Research (PAR) in four stages, comprising a situational analysis of maternal mortality through multidisciplinary brainstorming, planning and implementing solutions, and monitoring and evaluation, conducted from June 1, 2020 to May 31, 2024. Data analysis included descriptive statistics and comparative statistics using the Chi-square test and Independent t-test.
RESULTS: The development of the consultation and referral system, along with proactive care for high-risk groups through the establishment of a Preconception Care Clinic in collaboration with multidisciplinary teams, led to a significant increase in referrals due to medical conditions from 13 cases (1.6%) to 29 cases (3.5%) (p=0.03). The incidence of severe complications, such as HELLP syndrome, decreased from 7 cases (0.9%) to 1 case (0.1%), while cases of Eclampsia decreased from 4 (0.5%) to 0, both statistically significant (p<0.05). Maternal mortality rates decreased significantly from 9 cases (1.1%) to 1 case (0.1%) (p=0.01), with no postpartum hemorrhage-related deaths.
CONCLUSIONS: The development of the “One Province One Labor Room” system, in collaboration with a multidisciplinary team, significantly reduced maternal morbidity and mortality from both direct and indirect causes.
Thaiclinicaltrials.org number, TCTR20240915001
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