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Reduction of Maternal Mortality: Intercultural Care for Pregnancy and Childbirth at the Hospital of Tartagal, Salta, Argentina

Figar, S.; Murillo, A.; Campos, M.; Meoniz, J.; Palisa, E.; Quinteros, I.; Rivarossa, C.; Sosa, R.; Taborga, D.; Campero, M.; Agudin, L.; Zingoni, P.; Dorigato, G.

2025-05-08 obstetrics and gynecology
10.1101/2025.05.07.25326956 medRxiv
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ObjectiveTo describe the factors influencing the reduction of maternal mortality during the 2022-2024 management period at Tartagal Hospital (HT). MethodsParticipatory Action Research (PAR) with a qualitative-quantitative analysis. Twelve meetings and interviews were conducted with the healthcare team, along with 10 validated surveys administered to obstetric inpatients (10/12/24), and an analysis of hospital databases. ResultsSince 2022, the maternal mortality rate at HT has been reduced to zero. The main contributing factor was improved accessibility through the implementation of intercultural care along the maternal care pathway and respectful childbirth for Indigenous communities, based on the Primary Health Care Program. A total of 59 Community Health Workers participated by monitoring communities, providing priority transportation for at-risk pregnant women, and conducting nutritional follow-ups in coordination with social programs. Five transcultural facilitators (Wichi and Guarani) provided hospital support. Surveys showed a 90% compliance rate with Law 25.929 (Respectful Childbirth), with effective management of early mother-child contact. A need was identified to redesign wards, bathrooms, and lodging facilities for pregnant women from remote areas to strengthen this model. DiscussionHT demonstrated that intercultural, comprehensive, and territory-based management of pregnancy and childbirth led to a reduction in maternal mortality beginning in 2022. Teamwork and intersectoral collaboration optimized available resources, consolidating a sustainable and effective model for maternal health. However, the greatest challenge lies in maintaining and increasing funding to ensure the continuity of this policy.

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