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Sandra G. García, Karla Berdichevsky, Rosanne Rushing, and Eileen A. Yam. "Health intervention strategies to improve provider practice: A case study of magnesium sulfate use to treat pre-eclampsia in Mexico."

ABSTRACT

Globally there are an estimated 600,000 maternal deaths; 99 percent of these take place in developing countries. Pre-eclampsia is a key cause of morbidity and mortality for women and their newborns and accounts for over 50,000 maternal deaths annually. In Mexico, gestational hypertensive disorders, such as pre-eclampsia and eclampsia (pre/eclampsia) are the leading causes of maternal mortality. In 1998, the Magpie Trial conducted a review of anticonvulsants for pre-eclamptic women, which revealed that magnesium sulfate (MgSO4) halves the risk of eclampsia and reduces the risk of maternal death. Magnesium sulfate is the WHO drug of choice for women with eclampsia. Despite this evidence, MgSO4 is not widely used in developing countries. There is concern about the failure of health care providers to translate evidence-based research into practice. Data from our study on provider knowledge and practice show that obstetric care physicians in Mexico City hospitals state that WHO guidelines influence their decisionmaking, and they believe that MgSO4 is the drug of choice to prevent and treat pre/eclampsia. However, the majority of physicians surveyed do not use MgSO4 to treat pre/eclamptic convulsions resulting in poor health outcomes. The translation of evidence into policy and practice is vital to improving the evidence base of health care and outcomes. While evidence for improving reproductive health continues to grow, concerns remain that the translation of this evidence into appropriate policy and practice is partial and slow, and effective interventions remain underutilized. Therefore, targeted intervention strategies should be used to improve health care provider behavior.

Learning objectives

  • Identify potential barriers to translating research into practice.
  • Articulate policies related to maternal health care (notably magnesium sulfate use).
  • Discuss ways in which interventions can be used to improve provider practice.

Oral Session 4331.0—Issues in Maternal and Child Health
Tuesday, 6 November 2007, 4:30–6:00 pm

APHA 2007 Conference Web site
 

 



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2 October 2007