mHealth intervention to improve the continuum of maternal and perinatal care in rural Guatemala: a pragmatic, randomized controlled feasibility trial

Abstract

[...]at least 50% of births in rural Maya communities in Guatemala occur in the home under the care of Traditional Birth Attendants (TBAs) [7, 11]. [...]addressing the continuum of maternal and perinatal care in Guatemala requires not only increasing access to facility-level births, but also improving the early detection of complications in community-based care and the formal linkages of TBAs to higher levels of care [9–12]. [...]in an analysis of data from the international Global Network for Women’s and Children’s Health Research Maternal and Neonatal Health Registry—which includes data from the same region of Guatemala where this study occurred—hypertensive disorders were the strongest predictor of maternal death [22]. [...]pragmatic incorporation of the mHealth intervention into an existing primary care collaboration linking TBAs to the formal healthcare system allowed for more direct evaluation of the hypothesis that mHealth decision support could increase referral rates. [...]research needs to be conducted to explore the effects of mHealth systems on perinatal and maternal morbidity and mortality and to rigorously examine the impact of temporal trends and individual TBA practice variation on obstetrical referral.