Development of the care model for humanization of childbirth and its effectiveness in five pilot hospitals in El Salvador

2022 Fiscal Year Final Research Report

• Project/Area Number: 18K17552
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 58070:Lifelong developmental nursing-related
• Research Institution: The University of Tokyo
• Principal Investigator: Tahara-Sasagawa Emi 東京大学, 大学院医学系研究科(医学部), 助教 (90757270)
• Project Period (FY): 2018-04-01 – 2023-03-31
• Keywords: humanized care / childbirth / satisfaction / evidence based madicine / international health / El Salvador

Outline of Final Research Achievements

The concept 'Humanization of childbirth' refers to care during childbirth that takes a physiological process of childbirth as a natural activity of humans, avoids excessive medical intervention and respects the ability of mother and infant to bear and to be born. The effectiveness of the introduction of the "humanized childbirth care model" in El Salvador was evaluated through an obstetric care satisfaction survey of postpartum mothers (256 participants at baseline and 133 participants at endline) and a direct observation survey of obstetric care provided by health professionals (84 participants at baseline and 82 participants at endline). Obstetric care satisfaction increased significantly from 154 to 158 points (on a 200-point scale), and direct observation showed an increase in the percentage of care "recommended" by WHO guidelines, such as encouragement of oral fluid and food, and maternal mobility during delivery.

Free Research Field

Maternal and Child Health

Academic Significance and Societal Importance of the Research Achievements

WHOは、ミレニアム開発目標に掲げられた妊産婦死亡率の削減が多くの国で達成できなかった理由として、分娩時のケアの質の低さが障壁となったと評価している。分娩時のケアの質の向上は、女性の出産満足度を高めるだけでなく、妊産婦死亡率にも関わっていることが示唆された。そのため「人間的出産ケアモデル」の確立・導入を通じて、エルサルバドルの産科ケアの質の向上を図る本研究の意義は高い。また、中米の産科ケアの質を評価した研究はほとんど見当たらないことから、本研究は、中米の産科ケアの現状に関する基礎資料を提供することができると考えられる。