Age

Gender

Workplace

Years of service

70

M

Hospital

40

55

M

Hospital

30

38

F

Hospital

7

36

F

Hospital

8

62

M

Clinic

28

58

M

Clinic

20

65

M

Health Center

29

62

M

Health Center

25

40

M

Health Center

8

Emerging topics

Categories

Codes

Lack of adequate care procedures

Delays in the care processes

Each institution carries out procedures with the available resources

Limitations of the community model

Clinical barriers

Socio-cultural barriers

Administrative barriers

Difficulty to comply with guidelines and manuals

Processes are adapted according to existent resources

Not everyone is familiar with the proceduresto treat the obstetric emergency

It does not include midwives

Lack of translators of Mayan

The community doctor does not feel identified with the local people

Lack of good medical performance

Oversaturation of services

Lack of training in the management of obstetric emergencies

Lack of medical decisions

Bad attitude in terms of care

Communication difficulties regarding language

Home-based birth care

Scarce budget

Lack of transportation

Lack of space for triage

Lack of resources and equipment at the secondary level

Lack of operative programs

Type of strategy

Objective

Specific objective

Participation

Education

Information dissemination

Infrastructure and resources

To develop a participatory community model, includingmidwives, users, the health sector, and the education sector, focused more on prevention than on treatment

To train medical and non-medical staff 100%on obstetric emergencies at all levels

To give systematic training to
midwives

To give information on family planning after the obstetric event

To inform physicians and population of the negative impact of the medical claims on the doctor-patient relationship

To train community human resources to extend coverage

To provide  peripheral clinics with infrastructure and basic resources for the management of obstetric emergencies

To engage partners more so they are informed about family planning

To empower women in terms of decision-making processes with permanent information on family planning

To prevent pregnancies in women with chronic-degenerative diseases

To have  the university and the health sector develop an educational preconception proposal

To train physicians, psychologists, nurses, social workers, health aids, people in charge of transfer, drivers, midwives, etc. on the alarm signs of the pregnant woman with obstetric complication and the management of the obstetric complication

To achieve the acceptance of a contraceptive method before hospital discharge

To improve the quality of care of obstetric emergencies to reduce medical claims

To improve to access of remote communities to obstetric emergency care

To reduce the risk of maternal death during the transfer of women to hospitals outside their communities