Abstract
The Maternity in Dra. Eloísa Díaz’ hospital, located in the municipality of La Florida and city of Santiago, Chile, opened its doors in 2014, and has integrated a humanistic model of care called the “Safe Model of Personalized Childbirth” since 2016. With around 3,000 births per year, it has been recognized as an example of excellence in maternity care in the country. The COVID-19 outbreak presented a big challenge to this Maternity: to maintain its quality of care standards despite the health crisis. This article presents the Maternity’s responses to the pandemic from March to July 2020, describing the strategies that were deployed and the obstetric outcomes achieved. Semi-structured interviews with midwives and OB-GYNs, and a retrospective review of the childbirth standards of care and outcomes of the 55 women who tested positive for SARS-CoV-2, were carried out. The results show how the Maternity's staff responded in order to avoid a significant negative impact on the rights of women and newborns. Protocols to reestablish the companion during labor and childbirth and skin-to-skin contact, which were suspended for almost three weeks at the beginning of the outbreak, and the creation of an Instagram account to communicate with the external community were some of the measures taken. After some initial weeks of adjustment, the standards of care for all women, included for those diagnosed with COVID-19, were reestablished almost to pre-pandemic levels. This case shows that quality of care can be maintained and the rights of women and newborns can be respected during health crisis such as the COVID-19 pandemic.
Highlights
Chile and Its Healthcare SystemChile is a democratic republic located in South America, with a population of 17,574,003 inhabitants in 2017 (National Institute of Statistics, 2018)
During 2017, 8.6% of its population lived in poverty and 0.3% lived on less than $1.90USD per day (Ministry of Social Development and Family, 2018; World Bank, 2020)
Public spending represented 5.4% of Gross Domestic Product (GDP) and out-ofpocket spending accounted for 33.9% of health expenditures (OECD, 2020)
Summary
Chile is a democratic republic located in South America, with a population of 17,574,003 inhabitants in 2017 (National Institute of Statistics, 2018). It is considered a high-income country and had a Gross Domestic Product (GDP) per capita of US$25,041 in 2019 (World Bank, 2020). During 2017, 8.6% of its population lived in poverty and 0.3% lived on less than $1.90USD per day (Ministry of Social Development and Family, 2018; World Bank, 2020). The Chilean health system has maintained the structure that was defined during the 1980s (ECLAC, 2012), which consists of both public and private sector insurance and care provision, funded through social contributions (payroll taxes), general taxes, co-payments and voluntary premiums. The MAI does not require any extra out-of-pocket expenditure, and the MLE does entail out-ofpocket expenditure, which in September 2020 was around US$360 (National Public Health Insurance Fund, 2020)
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