PROJECT
Using a Non-pneumatic Anti-shock Garment (NASG) to Prevent Maternal Mortality in Rural Mexico
Globally, obstetric hemorrhage is a leading cause of maternal death, and in low-resource or remote rural areas, women often die because of long delays between the onset of hemorrhage and treatment at a health facility. The non-pneumatic anti-shock garment (NASG), a Neoprene and Velcro device that has been used in Egypt and Nigeria to prevent maternal mortality due to hemorrhage, can be applied to stabilize women long enough for them to travel to a treatment center. The NASG looks much like the bottom half of a wetsuit. It is wrapped tightly around a bleeding woman's legs and lower abdomen and helps returns blood from that region to her brain, heart, and lungs. The goal of this project was to explore the feasibility and acceptability of the NASG to prevent maternal mortality in rural Mexico.
In collaboration with colleagues from the University of California, San Francisco, Council researchers carried out an exploratory pilot study in healthcare facilities in rural Puebla and Oaxaca States in Mexico. Researchers conducted simple NASG trainings of healthcare providers in participating facilities. During the study period, the NASG was used on 20 women whose ages ranged from 16 to 42 years (mean, 29 years). Each of the participating states reported ten cases, two of which were referred from primary care settings to rural hospitals in Puebla.
Researchers also carried out more than 70 in-depth interviews with healthcare providers to document the perceptions and challenges of NASG use. Staff members at the community level were most immediately accepting of the NASG, and in many cases even those healthcare providers who did not fully understand the physiological principles by which the garment functioned expressed confidence about its utility. Many who expressed initial resistance to the NASG became more accepting once they witnessed its use on a patient.
Location
Puebla and Oaxaca States, Mexico
Duration
January 2004–January 2006
Population Council researchers
Karla Berdichevsky, Jennifer Catino, Sandra Garcia, Sofia Reynoso
Non-Council collaborators
Erin Bray (University of California, Berkeley)
Alberto Martinez (independent consultant)
Suellen Miller (University of California, San Francisco)
Christine Tucker (University of California, Berkeley)
Instituto Mexicano del Seguro Social (IMSS)
Donors
The William and Flora Hewlett Foundation
The John D. and Catherine T. MacArthur Foundation
Publications/Resources
Council researchers' names appear in boldface type.
2005
Miller, Suellen, Oladosu Ojengbede, Erin Bray, Felicia Lester, A.O. Fabamwo, Mohason Bello, OI Akinola, Karla Berdichevsky, Inova Campos, Jennifer Lynn Catino, Alberto Martinez, Juan Carlos Ledezma, Monique Webster, and Paul Hensleigh. "Ayorunbo: She who has been to heaven and returned—Near miss maternal mortality in Nigeria and Mexico," poster presentation at the American Public Health Association 133rd Annual Meeting and Exposition, Philadelphia, 13 December.
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