Control prenatal y su impacto en la mortalidad materna: Análisis de una tendencia, 1994-2004. Cali, Colombia Prenatal control and its impact on reducing maternal deaths: Trend analysis, 1994-2004. Cali, Colombia
Bibliographic record
Abstract
Objetivo: analizar el comportamiento de las razones de mortalidad materna en la ciudad de Cali (Colombia) durante dos décadas, 1985 a 2004, a la luz de indicadores de desarrollo social y organización de los servicios de atención a la gestante. Metodología: se utiliza como marco conceptual el modelo canadiense propuesto por Laframboise y Lalonde en 1974, para explicar la contribución de los servicios de salud en la disminución de las tasas de mortalidad materna. Resultados: a partir de 1994 se inició un descenso sostenido de la mortalidad materna, que se ha mantenido hasta el 2004. Durante este período no se evidenció un mejoramiento cuantitativo significativo de los indicadores de desarrollo social y económico de la ciudad de Cali. Las altas coberturas de atención prenatal (97%) y del parto institucional (98%), junto con un sistema eficiente de referencia y contrareferencia, se mantuvieron estables. El control de los procesos de mejoramiento de la calidad de la atención prenatal, con evaluaciones y ajustes periódicos, y la participación permanente de ginecobstetras en el nivel primario de atención, constituyeron los hitos primordiales de las intervenciones realizadas en la red de servicios públicos de atención. Discusión: los factores de riesgo intervenidos en la atención prenatal, la alta cobertura institucional de atención del parto y una red de referencia y contrareferencia de pacientes, oportuna y eficiente, parecen ser responsables de la disminución del 80% de las muertes, según el cálculo de Guzmán en 1986. Objective: analysing the statistical data regarding maternal deaths in Cali (Colombia) during two consecutive decades (1985-2004) and correlating outcomes with environmental and social indicators. Methodology: the Canadian Laframboise conceptual model was used for explaining how health service organisation and other aspects of medical care play a part in decreasing maternal mortality rates. Results: maternal deaths in Cali have been decreasing since 1994. No significant quantitative variations in environmental and/or social indicators for Cali were detected from 1994-2004. High prenatal control (97%) and institutional delivery coverage (98%) remained stable, together with an efficient referral and counter-referral system. Improving prenatal attention quality through periodic evaluation and adjustment and obstetrician/gynaecologists’ ongoing participation in first-level attention were the highlights of public attention service network intervention. Discussion: prenatal risk factors, broad institutional coverage for a quality motherhood care programme and an efficient referral system have all contributed towards reducing maternal deaths by nearly 80 (taking Guzmán’s 1986 calculation as reference point).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".