Can better infrastructure and quality reduce hospital infant mortality rates in Mexico?

Aguilera, Nelly; Marrufo, Grecia

doi:10.1016/j.healthpol.2006.03.003

Cited by 24 publications

(19 citation statements)

References 14 publications

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“…Our results are in accordance to previous study that reorganization of health system was of great value to eliminate inequality in health assistance improving health outcomes and results in lower PMR [18]. The political and administrative system and the organizational structure will strongly affect operations and, in turn, service outputs.…”

Section: Discussionsupporting

confidence: 91%

The safe motherhood referral system to reduce cesarean sections and perinatal mortality - a cross-sectional study [1995-2006]

et al. 2011

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BackgroundIn 2000, the eight Millennium Development Goals (MDGs) set targets for reducing child mortality and improving maternal health by 2015.ObjectiveTo evaluate the results of a new education and referral system for antenatal/intrapartum care as a strategy to reduce the rates of Cesarean sections (C-sections) and maternal/perinatal mortality.MethodsDesign: Cross-sectional study. Setting: Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University/UNESP, Brazil. Population: 27,387 delivering women and 27,827 offspring. Data collection: maternal and perinatal data between 1995 and 2006 at the major level III and level II hospitals in Botucatu, Brazil following initiation of a safe motherhood education and referral system. Main outcome measures: Yearly rates of C-sections, maternal (/100,000 LB) and perinatal (/1000 births) mortality rates at both hospitals. Data analysis: Simple linear regression models were adjusted to estimate the referral system's annual effects on the total number of deliveries, C-section and perinatal mortality ratios in the two hospitals. The linear regression were assessed by residual analysis (Shapiro-Wilk test) and the influence of possible conflicting observations was evaluated by a diagnostic test (Leverage), with p < 0.05.ResultsOver the time period evaluated, the overall C-section rate was 37.3%, there were 30 maternal deaths (maternal mortality ratio = 109.5/100,000 LB) and 660 perinatal deaths (perinatal mortality rate = 23.7/1000 births). The C-section rate decreased from 46.5% to 23.4% at the level II hospital while remaining unchanged at the level III hospital. The perinatal mortality rate decreased from 9.71 to 1.66/1000 births and from 60.8 to 39.6/1000 births at the level II and level III hospital, respectively. Maternal mortality ratios were 16.3/100,000 LB and 185.1/100,000 LB at the level II and level III hospitals. There was a shift from direct to indirect causes of maternal mortality.ConclusionsThis safe motherhood referral system was a good strategy in reducing perinatal mortality and direct causes of maternal mortality and decreasing the overall rate of C-sections.

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Section: Discussionsupporting

confidence: 91%

The safe motherhood referral system to reduce cesarean sections and perinatal mortality - a cross-sectional study [1995-2006]

et al. 2011

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“…Our focus is on child health given that only a decade has elapsed since the adoption of decentralisation and the well-documented lasting effects of childhood health on adult health and economic status (Case, Fertig, & Paxson, 2005;Case & Paxson, 2010). Additionally, taking into consideration that health services for neonates are highly dependent on health systems, more so than those for older children, we focus on the former (Aguilera & Marrufo, 2007;Darmstadt et al, 2005). For these purposes, we use random effects and correlated random effects models, which control for unobserved heterogeneity at community level, to examine the link between decentralisation and regional coverage of facility-based delivery.…”

Section: Introductionmentioning

confidence: 99%

Linkages between Decentralisation and Inequalities in Neonatal Health: Evidence from Indonesia

Hodge

Firth

Jimenez-Soto

et al. 2015

The Journal of Development Studies

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This study uses five waves of the Indonesian Demographic Health Surveys to analyse decentralisation and geographical inequality in health services delivery. Accounting for unobserved community-level heterogeneity with random effects and correlated random effects models, we link facility-based birth delivery to the period of decentralisation and Indonesia's major island groups using a pooled sample of 71,815 children. We also generate direct estimates of neonatal mortality from 1990 to 2007. The results show that the implementation of decentralisation has accorded with a marked expansion in both health service and outcome inequalities in Indonesia, at least with respect to neonates. Systemic funding failures for health and decision-space issues resulting from decentralisation are likely to have greater impact in disadvantaged regions where local capacity is weakest. The need to address these fundamental issues to reduce inequalities and improve general health outcomes appears supportable.

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“…Health Infrastructure: complications related to pregnancy (Molesworth, 2006); Condition such as birth injuries.premature originating in perinatal period (Aguilera & Marrufo, 2007).…”

Section: Resultsmentioning

confidence: 99%

Exploring health outcomes as a motivator for low-carbon city development: Implications for infrastructure interventions in Asian cities

Sperling¹,

Ramaswami²

2013

Habitat International

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Can better infrastructure and quality reduce hospital infant mortality rates in Mexico?

Cited by 24 publications

References 14 publications

The safe motherhood referral system to reduce cesarean sections and perinatal mortality - a cross-sectional study [1995-2006]

The safe motherhood referral system to reduce cesarean sections and perinatal mortality - a cross-sectional study [1995-2006]

Linkages between Decentralisation and Inequalities in Neonatal Health: Evidence from Indonesia

Exploring health outcomes as a motivator for low-carbon city development: Implications for infrastructure interventions in Asian cities

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