Although there are significant obstacles to improving maternal health in low- and middle-income countries, they can be overcome, according to Argentinian researcher Dr. Fernando Althabe. A prominent obstetrician and perinatal care expert, Althabe recently visited NIH to deliver the annual Lawton Chiles International Lecture on Maternal and Child Health in the Americas, which is co-sponsored by Fogarty and the National Institute of Child Health and Human Development.
Althabe described the challenges he has faced over the years while working to improve maternal health care in hospitals and clinics in South America. Though he encountered resistance to change - such as physicians’ attitudes and beliefs - Althabe said he also learned valuable lessons. “There are no magic bullets,” he said. “Interventions should be tailored to overcome specific barriers.”
With some Fogarty support, Althabe and his colleagues focused on implementing evidence-based approaches to procedures such as episiotomies and cesarean sections, both of which have become overutilized, he said.
One large-scale study sought to determine if a second opinion before a C-section could reduce the rate of the procedure. A more recent effort in Argentina and Uruguay evaluated whether a behavioral intervention could increase the use of beneficial childbirth practices in maternity hospitals.
Dr. Althabe currently heads a Fogarty-funded master’s program in clinical effectiveness for maternal health professionals and is overseeing two Fogarty fellows working at public hospitals in Argentina. He is also director of the Department of Mother and Child Research at the Institute for Clinical Effectiveness and Health Policy in Buenos Aires.