Indicator | Total | Exposed to the PPA model | Standard care group | Significance level1 | ||
---|---|---|---|---|---|---|
n | n | % (CI 95%) | n | % (CI 95%) | ||
Governance | ||||||
Training (G1) | Management interview | |||||
All | 2 | |||||
Two or less | 10 | |||||
Financial bonus (G2) | Management interview | |||||
No | 8 | |||||
Yes | 4 | |||||
Budget (G3) | Management interview | |||||
No | 4 | |||||
Yes | 8 | |||||
Participation of women | ||||||
Good practices info (W1) | ||||||
None | 497 | 292 | 19.8 (19.1–20.5) | 205 | 20.6 (19.3–21.7) | * |
At least one | 1976 | 1379 | 80.2 (79.4–80.9) | 597 | 79.4 (78.1–80.6) | |
Final pref (W2) | ||||||
Vaginal | 1468 | 1171 | 60.1 (58.9–60.9) | 297 | 59.3 (57.6–60.5) | * |
Caesarean/no preference | 1005 | 500 | 39.9 (39.1–40.7) | 505 | 40.7 (39.5–41.9) | |
Info PPA (W3) | ||||||
No | 1498 | 1030 | 39.8 (39.8–39.4) | 468 | 35.8 (34.5–37.0) | ** |
Yes | 975 | 641 | 60.2 (59.3–61.1) | 334 | 64.2 (62.6–65.5) | |
Women PPA (W4) | ||||||
No | 1310 | 845 | 51.9 (51.0–52.8) | 465 | 58.3 (56.9–59.6) | ** |
Yes | 1163 | 826 | 48.1 (47.0–49.1) | 337 | 41.7 (40.6–42.9) | |
Source info (W5) | ||||||
Hospital/insurance | 184 | 132 | 11.2 (10.6–11.7) | 52 | 10.6 (9.8–11.3) | * |
Others | 2289 | 1539 | 88.8 (88.2–89.6) | 750 | 89.4 (88.5–90.1) | |
Freq Act PPA (W6) | Management interview | |||||
Regular | 9 | |||||
Non regular | 3 | |||||
Ant group (W7) | ||||||
No | 1516 | 1016 | 60.0 (59.1–60.9) | 500 | 68.3 (66.9–69.2) | ** |
Yes | 957 | 655 | 40.0 (39.0–41.0) | 302 | 31.7 (30.5–33.1) | |
Visit hospital (W8) | ||||||
No | 1097 | 733 | 56.3 (55.1–57.1) | 364 | 45.9 (44.6–47.2) | ** |
Yes | 1376 | 938 | 43.7 (42.8–44.7) | 438 | 54.1 (52.9–55.4) | |
Birth plan (W9) | ||||||
Birth plan | 288 | 215 | 26.4 (25.5–27.3) | 73 | 18.1 (16.9–19.1) | ** |
No birth plan | 2185 | 1456 | 73.5 (72.7–74.4) | 729 | 81.8 (80.8–82.6) | |
Reorganization of Care | ||||||
Team model (R1) | ||||||
Hospital staff | 972 | 940 | 56.2 (55.1–56.9) | 32 | 3.9 (3.4–4.5) | ** |
External/hospital staff | 266 | 160 | 9.6 (9.0–10.0) | 106 664 | 13.4 (12.5–14.1) | |
External | 1235 | 571 | 34.1 (33.2–35.0) | 82.7 (81.6–83.7) | ||
Team labor (R2) | ||||||
Doctor | 579 | 476 | 23.7 (22.9–24.6) | 103 | 12.0 (11.1–12.7) | ** |
Doctor/nurse | 556 | 484 | 31.2 (30.3–32.0) | 72 | 18.4 (17.3–19.3) | |
No labor | 1338 | 711 | 45.1 (44.3–46.0) | 627 | 69.6 (68.3–70.7) | |
Schedule protocol (R3) | Management interview | |||||
No | 1 | |||||
> 39 weeks | 9 | |||||
> 40 or 41 weeks | 2 | |||||
Scheduled birth (R4) | ||||||
No | 1546 | 1263 | 74.8 (74.1–75.6) | 519,283 | 64.4 (63.1–65.5) | ** |
Yes | 927 | 408 | 25.2 (24.3–25.9) | 35.6 (34.1–36.6) | ||
Cervical dilatation (R5) | ||||||
< 4 | 238 | 206 | 12.3 (10.9–13.5) | 32 | 11.1 (9.8–13.9) | ** |
>= 4 | 897 | 754 | 45.2 (44.3–46.0) | 143 | 19.3 (18.0–20.4) | |
No labor | 1338 | 711 | 42.5 (41.7–43.6) | 627 | 69.6 (68.3–70.7) | |
Respect birth plan (R6) | ||||||
Respected | 251 | 191 | 16.5 (15.7–17.1) | 60 | 11.5 (10.6–12.2) | ** |
Not respected/partially | 37 | 24 | 10.0 (9.25–10.3) | 13 | 6.7 (6.0–7.4) | |
No birth plan | 2185 | 1456 | 73.5 (72.7–74.2) | 729 | 81.8 (80.8–83.1) | |
Hospital practices (R7) | ||||||
< 4 recommended | 478 | 380 | 28.4 (27.5–29.3) | 98 | 15.6 (14.6–16.6) | ** |
>= 4 recommended | 657 | 580 | 26.4 (25.0–27.6) | 77 | 14.8 (13.3–16.3) | |
No labor | 1338 | 711 | 45.2 (44.3–46.0) | 627 | 69.6 (68.3–70.7) | |
Monitoring | ||||||
Indicators (M1) | Management interview | |||||
<= 4 | 2 | |||||
> 4 | 10 | |||||
Feedback (M2) | Management interview | |||||
Each doctor | 6 | |||||
Doctors + Team | 3 | |||||
Doctors + Team + User | 3 | |||||
Freq Feedback (M3) | Management interview | |||||
No frequency | 6 | |||||
Regular | 1 | |||||
Irregular | 3 | |||||
Not monitor indicators | 2 | |||||
Confounders | ||||||
Economic class | ||||||
A | 467 | 375 | 18.9 (18.1–19.6) | 92 | 19.2 (17.8–20.0) | NS |
B | 1422 | 904 | 57.5 (56.6–58.4) | 218 | 57.3 (56.2–58.7) | |
C/D | 584 | 392 | 23.5 (22.8–24.4) | 192 | 23.5 (22.3–24.6) | |
Skin colour | ||||||
White | 1541 | 1102 | 62.4 (61.4–63.3) | 439 | 62.3 (60.9–63.7) | NS |
Non-white | 932 | 569 | 37.6 (36.7–38.8) | 363 | 37.7 (36.3–39.3) | |
Risk | ||||||
No | 1887 | 1296 | 77.5 (76.8–78.3) | 591 | 73.7 (72.5–74.8) | ** |
Yes | 586 | 375 | 22.5 (21.6–23.2) | 211 | 26.3 (24.9–27.3) | |
Outcome | ||||||
Birth type | ||||||
Vaginal/forceps | 699 | 37.7 (36.7–38.6) | 121 | 24.5 (23.5–25.7) | ** | |
Caesarean section | 972 | 62.3 (60.8–63.8) | 681 | 75.5 (74.2–76.8) |