Evaluating Access to Health Care in Mothers and Caregivers of Children under Five Years of Age in Rural Communities of Yucatán, Mexico.

Populations in rural communities have more limited access to health care and attention than urban populations. The present study aimed to evaluate barriers to access to health care in mothers and caregivers of children under five years of age, twelve months after an educational intervention. The study was carried out from February to September 2022, and 472 mothers from eight communities in the state of Yucatán, in the southeast of the United Mexican States, participated.

Tackling equitable coverage and quality of care for neonates in hospitals: a pre-post assessment on asphyxia interventions in Mesoamerica.

Background: Intrapartum-related hypoxic events, or birth asphyxia, causes one-fourth of neonatal deaths globally and in Mesoamerica. Multidimensional care for asphyxia must be implemented to ensure timely and effective care of newborns. Salud Mesoamérica Initiative (SMI) is a performance-based program seeking to improve maternal and child health for low-income areas of Central America.

Factors associated with delays in the search for care in under-5 deaths in Yucatán, Mexico.

Objective: We examined delays during the search for care and associations with mother, child, or health services characteristics, and with symptoms reported prior to death.

Materials And Methods: Cross-sectional study compris-ing household interviews with 252 caregivers of children under-5 who died in the state of Yucatán, Mexico, during 2015-2016. We evaluated the three main delays: 1) time to identify symptoms and start search for care, 2) transport time to health facility, and 3) wait time at health facility.

Access and use of oxytocin for postpartum haemorrhage prevention: a pre-post study targeting the poorest in six Mesoamerican countries.

Objectives: Haemorrhage remains the leading cause of maternal mortality in Central America. The Salud Mesoamérica Initiative aims to reduce such mortality via performance indicators. Our objective was to assess the availability and administration of oxytocin, before and after applying Salud Mesoamérica Initiative interventions in the poorest health facilities across Central America.

Assessing multidimensional care coverage for pre-eclampsia in the era of universal health coverage: A pre-post evaluation of the Salud Mesoamérica Initiative.

Objective: To compare a multidimensional care package for pre-eclampsia/eclampsia in Central American health facilities, before and after implementation of the Salud Mesoamérica Initiative.

Methods: An evaluation study was conducted at 67 basic- and comprehensive-level health facilities serving the poorest areas in Honduras, Nicaragua, and Belize. Cases of severe pre-eclampsia or eclampsia were randomly sampled and relevant quality of care data extracted from medical records at baseline (n=111) from January 1, 2011, to March 31, 2013, and at second-phase follow-up (n=249) from June 1, 2015, to September 30, 2017.

Results-based aid with lasting effects: sustainability in the Salud Mesoamérica Initiative.

Background: The Salud Mesoamérica Initiative is a public-private partnership aimed at reducing maternal and child morbidity and mortality for the poorest populations in Central America and the southernmost state of Mexico. Currently at the midpoint of implementation and with external funding expected to phase out by 2020, SMI's sustainability warrants evaluation. In this study, we examine if the major SMI components fit into the Dynamic Sustainability Framework to predict whether SMI benefits could be sustainable beyond the external funding and to identify threats to sustainability.