Repositorio
Institucional

Bautista-Valarezo, Estefania

Elena Espinosa, Maria

Michels, Nele R. M.

Hendrickx, Kristin

Verhoeven, Veronique

Culturally adapted flowcharts in obstetric emergencies: a participatory action research study

BMC

BMC PREGNANCY AND CHILDBIRTH

en

"Introduction Maternal mortality is a health problem in developing countries and is the result of several factors such as sociodemographic and economic inequalities and difficulties in accessing the health services. In addition, training strategies in obstetric emergencies targeting the non-medical personnel such as traditional midwives are scarce. The focus of this study is to develop learning and communication bridges on the management of obstetric emergencies and on policies of patients' referral to the biomedical health system in rural areas. Methodology A Participant Action Research (PAR) study with a mixed methods approach was set up to elaborate culturally adapted flowcharts. The project lasted approximately 3,5 years, from September 2016 to January 2021. Results The study was conducted with 94 traditional midwives from southern Ecuador and is divided into 4 phases, namely: 1) Exploration: focus groups and interviews were conducted to document the management of obstetric emergencies through the presentation of ""clinical case"" scenarios in three important topics, namely: pre-eclampsia, shoulder dystocia and postpartum hemorrhage, 2) Planning: a number of reflective sessions were conducted between the researchers and the healers/midwives to elaborate flowcharts. 3) Action: the training was conducted in rooms dedicated to proficiency in the aforementioned topics and using the flowcharts, 4) Evaluation: 90% of the participants reported having used the flowcharts during the first year after the training. The most frequently used flowchart was that of pre-eclampsia for the recognition of warning signs during pregnancy control. Conclusion This study documents common practices of pregnancy and delivery management by traditional midwives. Furthermore, cultural flowcharts were developed for and together with midwives to improve the clinical response to obstetric emergencies. The preliminary evaluation was favorable, the most frequently used flowchart concerned preeclampsia. In this process, establishing a partnership was crucial for successful intercultural collaboration."

artículo original

10.1186/s12884-022-05105-z

PDF

Flowcharts

Obstetric emergencies

Traditional midwives

Pre-eclampsia

Shoulder dystocia

Postpartum hemorrhage

OBJECTIVE DEFINITION

SHOULDER DYSTOCIA

HEALTH-CARE

IMPROVEMENT

Obstetricia y Ginecología

Diagramas de flujo

Emergencias obstétricas

Parteras tradicionales

Preeclampsia

Distocia de hombros

Hemorragia posparto

DEFINICIÓN OBJETIVO

DISTOCIA DE HOMBRO

CUIDADO DE LA SALUD

MEJORA

Obstetricia y Ginecología

Salud Pública y Ambiental

Servicios y Cuidados en Ciencias de la Salud

version publicada

dorada

verde

acceso abierto

acceso abierto

WOS:000867663600001

Culturally adapted flowcharts in obstetric emergencies: a participatory action research study

artículo original

CC BY 4.0

CC BY 4.0