A community-based randomised controlled trial was conducted in the district Larkana of Sindh province of Pakistan. The new model was based on reorganising the existing maternal health services. Three sub-districts were randomly assigned to the intervention group and four to the control group. The intervention consisted of integrating traditional birth attendants with the health care system, the use of safe delivery packs and the provision of antenatal care by doctors. Over one year 19,525 women were recruited and followed up. The proportion of referrals was higher in the intervention group (10.0 Vs 6.9 %; odds ratio 1.50 [95% Cl 1.26-1.74]). Significant differences were also found in some pregnancy complications including haemorrhage, obstructed labour and puerperal sepsis. Perinatal mortality in the intervention group was 83, compared to 118 per 1000 births for the control group, odds ratio 0.69 (95% Cl 0.53-0.85)(P<O.OOI). Maternal mortality ratio was also lower in the intervention group (303 Vs 439 per 100,000 live births), but this reduction did not achieve statistical significance (odds ratio 0.74,95% C I 0.23-1.24). Implementation of such a model could significantly improve the effectiveness of maternal health services in rural settings in Pakistan.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:390759 |
| Date | January 2001 |
| Creators | Jokhio, Abdul Hakeem |
| Publisher | University of Birmingham |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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