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The MOMENTUM study: Putting the 'Three Delays' to work to evaluate access to emergency obstetric and neonatal care in a remote island community in Western Kenya.
DesLauriers, Nicholas R; Ogola, Evance; Ouma, Gor; Salmen, Marcus; Muldoon, Lily; Pederson, Ben L; Hines, Kelsi; Ssenkusu, John M; Mattah, Brian; Okeyo, Robinson; Okinyi, Peres; Magerenge, Richard; Friberg, Nyika; McCoy, Molly; Prasad, Shailendra; Ndunyu, Louisa; Salmen, Charles R.
Afiliación
  • DesLauriers NR; Medical School, University of Minnesota, Minneapolis, USA.
  • Ogola E; Organic Health Response, Mfangano Island, Kenya.
  • Ouma G; Ekialo Kiona Centre, Mfangano Island, Kenya.
  • Salmen M; Department of Public Health, Maseno University, Kisumu, Kenya.
  • Muldoon L; Ekialo Kiona Centre, Mfangano Island, Kenya.
  • Pederson BL; Organic Health Response, Mfangano Island, Kenya.
  • Hines K; Organic Health Response, Mfangano Island, Kenya.
  • Ssenkusu JM; Organic Health Response, Mfangano Island, Kenya.
  • Mattah B; Organic Health Response, Mfangano Island, Kenya.
  • Okeyo R; School of Public Health, Makerere University, Kampala, Uganda.
  • Okinyi P; Ekialo Kiona Centre, Mfangano Island, Kenya.
  • Magerenge R; Ekialo Kiona Centre, Mfangano Island, Kenya.
  • Friberg N; Ekialo Kiona Centre, Mfangano Island, Kenya.
  • McCoy M; Ekialo Kiona Centre, Mfangano Island, Kenya.
  • Prasad S; Organic Health Response, Mfangano Island, Kenya.
  • Ndunyu L; Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, USA.
  • Salmen CR; Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, USA.
Glob Public Health ; 15(7): 1016-1029, 2020 07.
Article en En | MEDLINE | ID: mdl-32182159
Despite worldwide improvements in maternal and infant mortality, mothers and babies in remote, low-resource communities remain disproportionately vulnerable to adverse health outcomes. In these settings, delays in accessing emergency care are a major driver of poor outcomes. The 'Three Delays' model is now widely utilised to conceptualise these delays. However, in out-of-hospital contexts, operational and methodological constraints present major obstacles in practically quantifying the 'Three Delays'. Here, we describe a novel protocol for the MOMENTUM study (Monitoring of Maternal Emergency Navigation and Triage on Mfangano), a 12-month cohort design to assess delays during obstetric and neonatal emergencies within the remote villages of Mfangano Island Division, Lake Victoria, Kenya. This study also evaluates the preliminary impact of a community-based intervention called the 'Mfangano Health Navigation' programme. Utilising participatory case audits and contextually specific chronological reference strategies, this study combines quantitative tools with deeper-digging qualitative inquiry. This pragmatic design was developed to empower local research staff and study participants themselves as assets in unravelling the complex socio-economic, cultural, and logistical dynamics that contribute to delays, while providing real-time feedback for locally driven intervention. We present our methods as an adaptive framework for researchers grappling with similar challenges across fragmented, rural health landscapes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Servicios de Salud Rural / Servicios Médicos de Urgencia / Accesibilidad a los Servicios de Salud / Servicios de Salud Materna Tipo de estudio: Etiology_studies / Guideline / Incidence_studies / Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Female / Humans / Newborn / Pregnancy País/Región como asunto: Africa Idioma: En Revista: Glob Public Health Asunto de la revista: SAUDE PUBLICA Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Servicios de Salud Rural / Servicios Médicos de Urgencia / Accesibilidad a los Servicios de Salud / Servicios de Salud Materna Tipo de estudio: Etiology_studies / Guideline / Incidence_studies / Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Female / Humans / Newborn / Pregnancy País/Región como asunto: Africa Idioma: En Revista: Glob Public Health Asunto de la revista: SAUDE PUBLICA Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido