Healthy Birth: A Prospective Study to Evaluate the Implementation and Effects of an Intervention to Improve the Quality of Maternal and Neonatal Care in Brazilian Hospitals

Maria do Carmo Leal from Fiocruz in Brazil will undertake a pilot "Parto Adequado" (Adequate Birth) project to evaluate whether different health care models offered by medical institutions during pregnancy and childbirth can promote healthier births, particularly by reducing the rate of unnecessary medical procedures. These include caesarean section without clinical indication, which occur frequently in Brazil and can have negative consequences. They have selected 23 geographically dispersed hospitals for the pilot study, which will involve around 16,000 mothers. To promote good practices, they have developed three health care models that combine different numbers and types of medical staff (i.e., Doctors and nurses-midwives) to be involved at specific stages from pregnancy to birth. These will be offered to hospitals for implementation over 18 months. They will then analyse the degree of implementation of the models, and their effects on the type of birth, adoption of good practices, and hospital costs after two and three years. They will also interview the mothers and health care workers to evaluate acceptability of the different models.