title: Healthcare model based on personalised attention: impact on maternal mortality and health system quality.
abstract: BACKGROUND
  Latin America's public healthcare model has traditionally offered health services on demand including provision for the most deprived inhabitants. However, this care model has not provided the expected improvement in health conditions or equity for the indigent population.
  
  
  OBJECTIVE
  To compare maternal health indicators between previous services and a new healthcare model based on personalised care and a named healthcare worker.
  
  
  METHODS
  Pregnant women in La Plata, Argentina were observed during two periods: a control period using a historical model  and an intervention period where a new healthcare model was provided, each period lasting 12 months. Indicators of the quality of antenatal care services were measured, including mortality rate, number of pregnancy related consultations, vaccination coverage, gestational age at delivery, newborn  weight, laboratory and scan monitoring, early pregnancy detection and type of delivery.
  
  
  RESULTS
  The number of patients undergoing antenatal surveillance increased almost five-fold during the period of the new healthcare model. Also the rate of early detection of pregnancy, average  number of health consultations and vaccination coverage were significantly higher with the new model compared with previous care. Maternal gestation at delivery increased from 37.4±3.8% to 39.3±2.5% weeks (P<0.001) and neonatal weight increased from 3048 AE 612 g to  3301 AE 580 g (P=0.003). There were no maternal deaths in the intervention group compared with seven deaths in the control group. Child mortality rate was 13.7 and 11.8 per 1000 for control and intervention groups respectively (P=0.039).
  
  
  CONCLUSIONS
  A named responsible  health worker and personalised care helped contribute to improvements in quality of antenatal care in the health system.
authors.affiliation: Public Health System of La Plata, Argentina. gmarin@netverk.com.ar
authors.forename: Gustavo H
authors.initials: GH
authors.lastname: Marin
authors.forename: Martin
authors.initials: M
authors.lastname: Silberman
authors.forename: Adriana
authors.initials: A
authors.lastname: Uriarte
authors.forename: Monica
authors.initials: M
authors.lastname: Sarijulis
authors.forename: Belen
authors.initials: B
authors.lastname: Ozaeta
authors.forename: Jaime
authors.initials: J
authors.lastname: Henen
mesh_terms: D001118:Argentina / Q000453:epidemiology; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000592:standards*; D008428:Maternal Mortality; D017146:Models, Organizational; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D011785:Quality Assurance, Health Care