Resilience to maintain quality of intrapartum care in war torn Yemen: a retrospective pre-post study evaluating effects of changing birth volumes in a congested frontline hospital

Fragile and conflict-affected states contribute with more than 60% of the global burden of maternal mortality. There is an alarming need for research exploring maternal health service access and quality and adaptive responses during armed conflict. Taiz Houbane Maternal and Child Health Hospital in...

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Bibliographic Details
Published in:BMC pregnancy and childbirth 2021-01, Vol.21 (1), p.36-36, Article 36
Main Authors: Obel, Josephine, Martin, Antonio Isidro Carrion, Mullahzada, Abdul Wasay, Kremer, Ronald, Maaløe, Nanna
Format: Article
Language:English
Subjects:
Adaptive response
Adolescent
Adult
Apgar Score
Armed Conflicts
Audits
Birth Rate
Births
Caesarean section
Cesarean section
Cesarean Section - statistics & numerical data
Childbirth
Childbirth & labor
Confidence Intervals
Controlled Before-After Studies
Data collection
Delivery, Obstetric - methods
Delivery, Obstetric - statistics & numerical data
Efficiency, Organizational
Family planning
Female
Health Services Accessibility - organization & administration
Hospitals
Humanitarian response
Humans
Infant, Newborn
Labor, Induced - statistics & numerical data
Maternal & child health
Maternal mortality
Midwifery
Obstetrics
Outcome and Process Assessment, Health Care
Perinatal Care - standards
Perinatal Care - statistics & numerical data
Perinatal Death
Physicians
Pregnancy
Pregnancy Outcome
Quality of care
Quality of Health Care - standards
Retrospective Studies
Stillbirth - epidemiology
Vagina
Womens health
Yemen
Young Adult
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Summary:Fragile and conflict-affected states contribute with more than 60% of the global burden of maternal mortality. There is an alarming need for research exploring maternal health service access and quality and adaptive responses during armed conflict. Taiz Houbane Maternal and Child Health Hospital in Yemen was established during the war as such adaptive response. However, as number of births vastly exceeded the facility's pre-dimensioned capacity, a policy was implemented to restrict admissions. We here assess the restriction's effects on the quality of intrapartum care and birth outcomes. A retrospective before and after study was conducted of all women giving birth in a high-volume month pre-restriction (August 2017; n = 1034) and a low-volume month post-restriction (November 2017; n = 436). Birth outcomes were assessed for all births (mode of birth, stillbirths, intra-facility neonatal deaths, and Apgar score 
ISSN:1471-2393
1471-2393
DOI:10.1186/s12884-020-03507-5