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Maternity waiting home as a potential intervention for reducing the maternal mortality ratio in El Salvador: an observational case study
BACKGROUND: El Salvador is recognized as a country that has effectively reduced its Maternal Mortality Ratio (MMR). While health indicators, such as total fertility rate, adolescent fertility rate, skilled birth attendance, and health expenditures, have improved in El Salvador, this improvement was...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8690890/ https://www.ncbi.nlm.nih.gov/pubmed/34930447 http://dx.doi.org/10.1186/s13690-021-00752-8 |
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author | Yoon, Hee sang Kim, Chong-Sup |
author_facet | Yoon, Hee sang Kim, Chong-Sup |
author_sort | Yoon, Hee sang |
collection | PubMed |
description | BACKGROUND: El Salvador is recognized as a country that has effectively reduced its Maternal Mortality Ratio (MMR). While health indicators, such as total fertility rate, adolescent fertility rate, skilled birth attendance, and health expenditures, have improved in El Salvador, this improvement was unremarkable compared to advancements in other developing countries. How El Salvador could achieve an outstanding decrease in MMR despite unexceptional improvements in health and non-health indicators is a question that deserves deep research. We used quantitative methods and an observational case study to show that El Salvador could reduce its MMR more than expected by instituting health policies that not only aimed to reduce the (adolescent) fertility rate, but also provide safe birthing conditions and medical services to pregnant women through maternity waiting homes. METHODS: We ran pooled ordinary least squares regression and panel regression with fixed effects using MMR as the dependent variable and health and non-health factors as the independent variables. We conducted residual analysis, calculated the predicted value of MMR, and compared it with the observed value in El Salvador. To explain the change in MMR in El Salvador, we carried out an observational case study of maternity waiting homes in that country. RESULTS: El Salvador could reduce MMR by improving health factors such as fertility rate skilled birth attendance and non-health factors, such as gross domestic product (GDP) per capita and female empowerment. However, even while considering these factors, the MMR of El Salvador decreased by more than expected. We confirmed this by analyzing the residuals of the regression model. This improvement in MMR, which is larger than expected from the regression results, can be attributed partly to government measures such as maternity waiting homes. CONCLUSIONS: The reason for the unexplained reduction in El Salvador’s MMR seems to be attributed in part to health policies that not only aim to reduce the fertility rate but also to provide safe birthing conditions and medical services to pregnant women through maternity waiting homes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13690-021-00752-8. |
format | Online Article Text |
id | pubmed-8690890 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-86908902021-12-21 Maternity waiting home as a potential intervention for reducing the maternal mortality ratio in El Salvador: an observational case study Yoon, Hee sang Kim, Chong-Sup Arch Public Health Research BACKGROUND: El Salvador is recognized as a country that has effectively reduced its Maternal Mortality Ratio (MMR). While health indicators, such as total fertility rate, adolescent fertility rate, skilled birth attendance, and health expenditures, have improved in El Salvador, this improvement was unremarkable compared to advancements in other developing countries. How El Salvador could achieve an outstanding decrease in MMR despite unexceptional improvements in health and non-health indicators is a question that deserves deep research. We used quantitative methods and an observational case study to show that El Salvador could reduce its MMR more than expected by instituting health policies that not only aimed to reduce the (adolescent) fertility rate, but also provide safe birthing conditions and medical services to pregnant women through maternity waiting homes. METHODS: We ran pooled ordinary least squares regression and panel regression with fixed effects using MMR as the dependent variable and health and non-health factors as the independent variables. We conducted residual analysis, calculated the predicted value of MMR, and compared it with the observed value in El Salvador. To explain the change in MMR in El Salvador, we carried out an observational case study of maternity waiting homes in that country. RESULTS: El Salvador could reduce MMR by improving health factors such as fertility rate skilled birth attendance and non-health factors, such as gross domestic product (GDP) per capita and female empowerment. However, even while considering these factors, the MMR of El Salvador decreased by more than expected. We confirmed this by analyzing the residuals of the regression model. This improvement in MMR, which is larger than expected from the regression results, can be attributed partly to government measures such as maternity waiting homes. CONCLUSIONS: The reason for the unexplained reduction in El Salvador’s MMR seems to be attributed in part to health policies that not only aim to reduce the fertility rate but also to provide safe birthing conditions and medical services to pregnant women through maternity waiting homes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13690-021-00752-8. BioMed Central 2021-12-20 /pmc/articles/PMC8690890/ /pubmed/34930447 http://dx.doi.org/10.1186/s13690-021-00752-8 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Yoon, Hee sang Kim, Chong-Sup Maternity waiting home as a potential intervention for reducing the maternal mortality ratio in El Salvador: an observational case study |
title | Maternity waiting home as a potential intervention for reducing the maternal mortality ratio in El Salvador: an observational case study |
title_full | Maternity waiting home as a potential intervention for reducing the maternal mortality ratio in El Salvador: an observational case study |
title_fullStr | Maternity waiting home as a potential intervention for reducing the maternal mortality ratio in El Salvador: an observational case study |
title_full_unstemmed | Maternity waiting home as a potential intervention for reducing the maternal mortality ratio in El Salvador: an observational case study |
title_short | Maternity waiting home as a potential intervention for reducing the maternal mortality ratio in El Salvador: an observational case study |
title_sort | maternity waiting home as a potential intervention for reducing the maternal mortality ratio in el salvador: an observational case study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8690890/ https://www.ncbi.nlm.nih.gov/pubmed/34930447 http://dx.doi.org/10.1186/s13690-021-00752-8 |
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