Effects of the Use of PMMR-Health Model for Reducing Maternal Deaths in Health Region 10, Thailand

Abstract

The aims of this action research were to study the factors related to maternal death, develop model and study of results using the PMMR-Health Model for reducing maternal death in the Public Health Region 10. It was conducted during October 2016 - March 2019. The sample consisted of experts and persons responsible for maternal and child health, selected by the purposive sampling technique. Investigation of maternal death form, interview form, group discussion form and opinion questionnaire was constructed and used as tool for data collection; and the data were analyzed by using descriptive statistics and content analysis. The study found that the factors related to maternal death problems include unclear policy, personnel lack skills, Inappropriate referral systems, pregnant women lack awareness of antenatal care such as late initiation of antenatal care, incomplete adherence to antenatal visit and teenage pregnancy. The PMMR-Health Model was developed to reduce maternal death, which consists of 5 components: (1) P: Policy, policy and implementation (2) M: Man, competency criteria and evaluating competency (3) M: Material, equipment, medication and blood are ready for Immediate (4) R: Risk management, screening and risk management (5) Health: Health communication, educating pregnant women and their families. Appying the model for reducing maternal mortality in 2 areas revealed that the ratio of maternal mortality tended to decrease, in which no maternal death in one province and reduction of maternal mortality in another province. In addition, the PMMR-Health model was consistent with national policy on reducing maternal death; and the model could be make the practitioners fell confident in the care and risk management in pregnant women, especially in hospitals without an obstetrician. However, long-term research and evaluation should be conducted in comparison with other areas in order to obtain a suitable model for the areas with different contexts in the public and private sectors.