Evaluation of Strategies to Reduce Maternal Mortality from COVID-19 Infection in Regional Health 12, Thailand

Abstract

Case fatality rate among mothers with COVID-19 infection in Regional Health 12 was very high in the initial period. Strategies to reduce maternal mortality have been urgently implemented. The objective of this study was to evaluate the efficacy of these interventions in reducing maternal mortality within the region. A descriptive study was conducted, using secondary data from a database developed by the collaborative team from the Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Regional Health Promotion Center 12 Yala, Regional Health Office 12, and National Health Security Office Region 12 Songkhla, from April 2021 to March 2022. Strategies were implemented on September 8, 2021, following consensus from the Maternal Child Health Board of Regional Health 12. These strategies included (1) maximizing COVID-19 vaccination coverage for pregnant women; (2) implementing rapid diagnosis and treatment systems at community entry points and facilitating swift referrals for treatment; and (3) establishing a database of mothers infected with COVID-19 to generate information for surveillance and action plan adjustments. An action plan was executed and outcomes were continuously assessed. Of the 1,818 mothers infected with COVID-19, 20 resulted in fatalities. Maternal deaths showed a steady declined, notably by the conclusion of the postimplementation period (October 2021 to March 2022), with no reports of maternal deaths in the last two months. A comparative analysis between the pre-implementation (April to September 2021) and the post-implementation (October 2021 to March 2022) periods using Chi-square test revealed significant improvements: vaccination coverage increased from 24.7% to 48.8% (p<0.001), remdesivir administration rates rose from 14.7% to 19.8% (p=0.047), case fatality rates notably decreased from 2.2% to 0.5% (p<0.001), and pneumonia rates continuously decreased from 7.3% to 3.7% (p<0.001). The implemented strategies effectively reduced case fatality rate from COVID-19 infection within Regional Health 12, demonstrating their potential applicability to future emerging diseases.