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Escobar MF, Echavarría MP, Carvajal JA, Lesmes MC, Porras AM, Mesa V, Ávila-Sánchez FA, Gallego JC, Riascos NC, Hurtado D, Fernández PA, Posada L, Hernández AM, Ramos I, Irurita MI, Loaiza JS, Echeverri D, Gonzalez L, Peña-Zárate EE, Libreros-Peña L, Galindo JS, Granados M. Hospital padrino: a collaborative strategy model to tackle maternal mortality: a mixed methods study in a middle-income region. Lancet Reg Health Am 2024; 31:100705. [PMID: 38445021 PMCID: PMC10912672 DOI: 10.1016/j.lana.2024.100705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/13/2024] [Accepted: 02/16/2024] [Indexed: 03/07/2024]
Abstract
Background Reducing maternal mortality ratio (MMR) remains a paramount goal for low- and middle-income countries (LMICs), especially after COVID-19's devastating impact on maternal health indicators. We describe our experience implementing the Hospital Padrino Strategy (HPS), a collaborative model between a high-complexity hospital (Fundación Valle del Lili) and 43 medium- and low-complexity hospitals in one Colombian department (an administrative and territorial division) from 2021 to 2022, to sustain the trend towards reducing MMR. The study aimed to assess the effects of implementing HPS on both hospital performance and maternal health indicators in Valle del Cauca department (VCD). Methods A mixed-methods study was conducted, comprising two phases. In the first phase, we investigated a cohort of hospitals through prospective follow-up to assess the outcomes of HPS implementation on hospital performance and maternal health indicators in VCD. In the second phase, qualitative data were collected through focus groups with 131 health workers from 33 hospitals to explore the implications of the HPS implementation on healthcare personnel. All data were obtained from records within the HPS implementation and from the Health Secretary of VCD. Findings Evidence shows that in the context of HPS, 51 workshops involved 980 healthcare workers, covering the entire territory. Substantial improvements were observed in hospital conditions and healthcare personnel's technical competencies when providing obstetric care. Seven hundred eighty-five pregnant women with obstetric or perinatal emergencies received care through telehealth systems, with a progressive increase in technology adoption. Nine percent required Intensive Care Unit (ICU) admission, and none died. The MMR decreased from 78.8 in 2021 to 12.0 cases per 100,000 live births by 2022. Improvements in indicators and conducted training sessions instilled confidence and empowerment among the healthcare teams in the sponsored hospitals, as evidenced in focus groups derived from a sample of 131 healthcare workers from 33 hospitals. Interpretation Implementing the Hospital Padrino Strategy led to a significant MMR reduction, and consolidated a model of social healthcare innovation replicable in LMICs. Funding The Hospital Padrino Strategy was funded by the Fundación Valle del Lili and the Health Secretary of Valle del Cauca. Furthermore, this study received funding from a general grant for research from Tecnoquimicas S.A.
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Affiliation(s)
- María Fernanda Escobar
- Unidad de Equidad Global en Salud, Fundación Valle del Lili, Cra. 98 no. 18-49, Cali 760032, Colombia
- Departamento de Ginecología y Obstetricia, Fundación Valle del Lili, Cra. 98 no. 18-49, Cali 760032, Colombia
- Facultad de Ciencias de la Salud, Universidad Icesi, Calle 18 No. 122-135, Cali, Colombia
| | - María Paula Echavarría
- Unidad de Equidad Global en Salud, Fundación Valle del Lili, Cra. 98 no. 18-49, Cali 760032, Colombia
- Departamento de Ginecología y Obstetricia, Fundación Valle del Lili, Cra. 98 no. 18-49, Cali 760032, Colombia
- Facultad de Ciencias de la Salud, Universidad Icesi, Calle 18 No. 122-135, Cali, Colombia
| | - Javier Andrés Carvajal
- Departamento de Ginecología y Obstetricia, Fundación Valle del Lili, Cra. 98 no. 18-49, Cali 760032, Colombia
| | | | | | - Viviana Mesa
- Departamento de Ginecología y Obstetricia, Fundación Valle del Lili, Cra. 98 no. 18-49, Cali 760032, Colombia
- Facultad de Ciencias de la Salud, Universidad Icesi, Calle 18 No. 122-135, Cali, Colombia
| | - Fernando A Ávila-Sánchez
- Departamento de Ginecología y Obstetricia, Fundación Valle del Lili, Cra. 98 no. 18-49, Cali 760032, Colombia
- Facultad de Ciencias de la Salud, Universidad Icesi, Calle 18 No. 122-135, Cali, Colombia
| | - Juan Carlos Gallego
- Departamento de Ginecología y Obstetricia, Fundación Valle del Lili, Cra. 98 no. 18-49, Cali 760032, Colombia
- Facultad de Ciencias de la Salud, Universidad Icesi, Calle 18 No. 122-135, Cali, Colombia
| | - Natalia C Riascos
- Departamento de Ginecología y Obstetricia, Fundación Valle del Lili, Cra. 98 no. 18-49, Cali 760032, Colombia
- Facultad de Ciencias de la Salud, Universidad Icesi, Calle 18 No. 122-135, Cali, Colombia
| | - David Hurtado
- Departamento de Ginecología y Obstetricia, Fundación Valle del Lili, Cra. 98 no. 18-49, Cali 760032, Colombia
- Facultad de Ciencias de la Salud, Universidad Icesi, Calle 18 No. 122-135, Cali, Colombia
| | - Paula A Fernández
- Facultad de Ciencias de la Salud, Universidad Icesi, Calle 18 No. 122-135, Cali, Colombia
| | - Leandro Posada
- Facultad de Ciencias de la Salud, Universidad Icesi, Calle 18 No. 122-135, Cali, Colombia
| | | | - Isabella Ramos
- Facultad de Ciencias de la Salud, Universidad Icesi, Calle 18 No. 122-135, Cali, Colombia
| | | | | | - Daniel Echeverri
- Fundación para el Desarrollo Integral del Pacífico - Propacífico, Cali, Colombia
| | - Luisa Gonzalez
- Unidad de Responsabilidad Social, Fundación Valle del Lili, Cra. 98 no. 18-49, Cali 760032, Colombia
| | - Evelyn Elena Peña-Zárate
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cra. 98 no. 18-49, Cali 760032, Colombia
| | - Laura Libreros-Peña
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cra. 98 no. 18-49, Cali 760032, Colombia
| | - Juan Sebastián Galindo
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cra. 98 no. 18-49, Cali 760032, Colombia
| | - Marcela Granados
- Subdirección General, Fundación Valle del Lili, Cra. 98 no. 18-49, Cali 760032, Colombia
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Hurtado IC, Hurtado JS, Valencia SL, Pinzón EM, Guzmán AR, Lesmes MC. Reinfection by SARS CoV2 in Valle Del Cauca, Colombia: A Descriptive Retrospective Study. INQUIRY 2022; 59:469580221096528. [PMID: 35574692 PMCID: PMC9109169 DOI: 10.1177/00469580221096528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Introduction: In coronavirus cases, reinfection has been associated with short-term immunity and genetic changes in viruses which allow them to escape from immune response, viral genotyping is required to make the precise diagnosis of reinfection, but the suspicion occurs in patients with more than 90 days between the tests and total improvement between them. We made a descriptive retrospective study with the cases of reinfection in Valle del Cauca, Colombia. Results: We found up to June 30, 3249 cases with suspected reinfection, 1.1% of all cases. During the first infection episode, 68% of the patients had symptoms, while at the moment of reinfection, the percentage was 73.4%. 55% of the analyzed cases had symptoms in both infection episodes, hospitalization of reinfection cases was 2% during the first episode and 2.2% in the second one. Conclusion: the reinfection percentage was low, as well as the hospitalization and ICU cases. These results allow to define that in terms of the provision of healthcare services, reinfection defined in this study, does not generate any differences in care required vs the first episode.
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