O477 STATUS OF EMERGENCY OBSTETRIC CARE IN SIX DEVELOPING COUNTRIES 5 YEARS BEFORE THE MDG TARGETS FOR MATERNAL AND NEWBORN HEALTH

2012 ◽  
Vol 119 ◽  
pp. S430-S430
Author(s):  
C.A. Ameh ◽  
S. Msuya ◽  
J. Hofman ◽  
J. Raven ◽  
M. Mathai ◽  
...  
Keyword(s):  
Developing Countries ◽  
Emergency Obstetric Care ◽  
Newborn Health ◽  
Obstetric Care ◽  
Maternal And Newborn Health ◽  
Maternal And Newborn

scholarly journals Status of Emergency Obstetric Care in Six Developing Countries Five Years before the MDG Targets for Maternal and Newborn Health

PLoS ONE ◽  
2012 ◽  
Vol 7 (12) ◽  
pp. e49938 ◽  
Author(s):  
Charles Ameh ◽  
Sia Msuya ◽  
Jan Hofman ◽  
Joanna Raven ◽  
Matthews Mathai ◽  
...  
Keyword(s):  
Developing Countries ◽  
Emergency Obstetric Care ◽  
Newborn Health ◽  
Obstetric Care ◽  
Maternal And Newborn Health ◽  
Maternal And Newborn

scholarly journals “The midwife helped me... Otherwise I could have died” Women’s experience of professional midwifery services in rural Afghanistan.  A qualitative study in the provinces Kunar and Laghman

2020 ◽  
Author(s):  
Trude Thommesen ◽  
Hallgeir Kismul ◽  
Ian Kaplan ◽  
Khadija Safi ◽  
Graziella Van den Berg
Keyword(s):  
Professional Education ◽  
Quality Care ◽  
Emergency Obstetric Care ◽  
Newborn Health ◽  
Skilled Birth Attendant ◽  
Obstetric Care ◽  
Maternal And Newborn Health ◽  
Skin Contact ◽  
Birth Attendance ◽  
Maternal And Newborn

Abstract Background Afghanistan has one of the world’s highest maternal mortality ratios, in some areas more than 60% of women have no access to a skilled birth attendant. The main challenges for Afghan childbearing women are access to skilled birth attendance, emergency obstetric care and reliable contraception. The NGO-based project Advancing Maternal and Newborn Health in Afghanistan has supported education of midwives since 2002, according to the national plan for midwifery education. The aim of this study is to explore women´s experiences with professional midwifery care in four villages in Afghanistan covered by the project, to uncover challenges and improve services in rural and conflict-affected areas of the country. Methods An explorative case study approach was adopted. Fourteen in-depth interviews and four focus group discussions were conducted. Totally, 39 women participated; 25 who had given birth during the last six months, 11 mothers-in-laws and three community midwives in the provinces of Kunar and Laghman. Data generated by the interviews and observations was analysed through a thematic content analysis. Findings The women reported that the trained midwives’ life-saving competence, skills and care were important reasons for giving birth in a clinic, and the midwives seemed to be appreciated by many of the women, making more women to choose to give birth in the clinic. Women further appreciated midwives’ promotion of immediate skin-to-skin contact and breastfeeding. However, some women experienced rudeness, discrimination and negligence from the midwives. Moreover, disapproval from relatives, shame and problems with transport and security were important obstacles to women giving birth in the clinics. Conclusions Local recruitment and professional education of midwives as promoted by Afghan authorities and applied in the project seem successful in promoting utilization and satisfaction with maternal and newborn health services in rural Afghanistan. Nevertheless, the quality of the services is still wanting, with some women complaining of disrespectful care. There seems to be a need to focus more on communication issues during the education of midwives. An increased focus on in-service training and factors promoting quality care and respectful communication is necessary and should be prioritized.

scholarly journals “The midwife helped me... Otherwise I could have died” Women’s experience of professional midwifery services in rural Afghanistan.  A qualitative study in the provinces Kunar and Laghman

2019 ◽  
Author(s):  
Trude Thommesen ◽  
Hallgeir Kismul ◽  
Ian Kaplan ◽  
Khadija Safi ◽  
Graziella Van den Berg
Keyword(s):  
Professional Education ◽  
Quality Care ◽  
Emergency Obstetric Care ◽  
Newborn Health ◽  
Skilled Birth Attendant ◽  
Obstetric Care ◽  
Maternal And Newborn Health ◽  
Skin Contact ◽  
Birth Attendance ◽  
Maternal And Newborn

Abstract Background Afghanistan has one of the world’s highest maternal mortality ratios, in some areas more than 60% of women have no access to a skilled birth attendant. The main challenges for Afghan childbearing women are access to skilled birth attendance, emergency obstetric care and reliable contraception. The NGO-based project Advancing Maternal and Newborn Health in Afghanistan has supported education of midwives since 2002, according to the national plan for midwifery education. The aim of this study is to explore women´s experiences with professional midwifery care in four villages in Afghanistan covered by the project, to uncover challenges and improve services in rural and conflict-affected areas of the country.MethodsAn explorative case study approach was adopted. Fourteen in-depth interviews and four focus group discussions were conducted. Totally, 39 women participated; 25 who had given birth during the last six months, 11 mothers-in-laws and three community midwives in the provinces of Kunar and Laghman. Data generated by the interviews and observations was analysed through a thematic content analysis.Findings The women reported that the trained midwives’ life-saving competence, skills and care were important reasons for giving birth in a clinic, and the midwives seemed to be appreciated by many of the women, making more women to choose to give birth in the clinic. Women further appreciated midwives’ promotion of immediate skin-to-skin contact and breastfeeding. However, some women experienced rudeness, discrimination and negligence from the midwives. Moreover, disapproval from relatives, shame and problems with transport and security were important obstacles to women giving birth in the clinics.Conclusions Local recruitment and professional education of midwives as promoted by Afghan authorities and applied in the project seem successful in promoting utilization and satisfaction with maternal and newborn health services in rural Afghanistan. Nevertheless, the quality of the services is still wanting, with some women complaining of disrespectful care. There seems to be a need to focus more on communication issues during the education of midwives. An increased focus on in-service training and factors promoting quality care and respectful communication is necessary and should be prioritized.

scholarly journals Effect of results-based financing on facility-based maternal mortality at birth: an interrupted time-series analysis with independent controls in Malawi

2019 ◽  
Vol 4 (3) ◽  
pp. e001184
Author(s):  
Manuela De Allegri ◽  
Rachel P Chase ◽  
Julia Lohmann ◽  
Anja Schoeps ◽  
Adamson S Muula ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Newborn Health ◽  
Obstetric Care ◽  
Interrupted Time Series ◽  
Maternal And Newborn Health ◽  
Maternal Deaths ◽  
Care Facilities ◽  
The Impact ◽  
Maternal And Newborn ◽  
Results Based Financing

IntroductionThe aim of this study was to assess the impact of a results-based financing (RBF) programme on the reduction of facility-based maternal mortality at birth. Malawi is a low-income country with high maternal mortality. The Results-Based Financing For Maternal and Newborn Health (RBF4MNH) Initiative was introduced at obstetric care facilities in four districts to improve quality and utilisation of maternal and newborn health services. The RBF4MNH Initiative was launched in April 2013 as a combined supply-side and demand-side RBF. Programme expansion occurred in October 2014.MethodsControlled interrupted time series was used to estimate the effect of the RBF4MNH on reducing facility-based maternal mortality at birth. The study sample consisted of all obstetric care facilities in 4 intervention and 19 control districts, which constituted all non-urban mainland districts in Malawi. Data for obstetric care facilities were extracted from the Malawi Health Management Information System. Facility-based maternal mortality at birth was calculated as the number of maternal deaths per all deliveries at a facility in a given time period.ResultsThe RBF4MNH effectively reduced facility-based maternal mortality by 4.8 (−10.3 to 0.7, p<0.1) maternal deaths/100 000 facility-based deliveries/month after reaching full operational capacity in October 2014. Immediate effects (changes in level rather than slope) attributable to the RBF4MNH were not statistically significant.ConclusionThis is the first study evaluating the effect of a combined supply-side and demand-side RBF on maternal mortality outcomes and demonstrates the positive role financial incentives can play in improving health outcomes. This study further shows that timeframes spanning several years might be necessary to fully evaluate the impact of health-financing programmes on health outcomes. Further research is needed to assess the extent to which the observed reduction in facility-based mortality at birth contributes to all-cause maternal mortality in the country.

scholarly journals Maternal and newborn health risks of climate change: A call for awareness and global action

2021 ◽  
Author(s):  
Nathalie Roos ◽  
Sari Kovats ◽  
Shakoor Hajat ◽  
Veronique Filippi ◽  
Matthew Chersich ◽  
...  
Keyword(s):  
Climate Change ◽  
Health Risks ◽  
Newborn Health ◽  
Maternal And Newborn Health ◽  
Global Action ◽  
Maternal And Newborn

scholarly journals Intersectional (in) equities in contact coverage of maternal and newborn health services in Nepal: insights from a nationwide cross-sectional household survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Resham B. Khatri ◽  
Yibeltal Alemu ◽  
Melinda M. Protani ◽  
Rajendra Karkee ◽  
Jo Durham
Keyword(s):  
Institutional Delivery ◽  
Secondary Analysis ◽  
Newborn Health ◽  
Household Survey ◽  
Universal Coverage ◽  
Maternal And Newborn Health ◽  
Multiple Forms ◽  
Wealth Status ◽  
Cross Sectional ◽  
Maternal And Newborn

Abstract Background Persistent inequities in coverage of maternal and newborn health (MNH) services continue to pose a major challenge to the health-care system in Nepal. This paper uses a novel composite indicator of intersectional (dis) advantages to examine how different (in) equity markers intersect to create (in) equities in contact coverage of MNH services across the continuum of care (CoC) in Nepal. Methods A secondary analysis was conducted among 1978 women aged 15–49 years who had a live birth in the two years preceding the survey. Data were derived from the Nepal Demographic and Health Survey (NDHS) 2016. The three outcome variables included were 1) at least four antenatal care (4ANC) visits, 2) institutional delivery, and 3) postnatal care (PNC) consult for newborns and mothers within 48 h of childbirth. Independent variables were wealth status, education, ethnicity, languages, residence, and marginalisation status. Intersectional (dis) advantages were created using three socioeconomic variables (wealth status, level of education and ethnicity of women). Binomial logistic regression analysis was employed to identify the patterns of (in) equities in contact coverage of MNH services across the CoC. Results The contact coverage of 4ANC visits, institutional delivery, and PNC visit was 72, 64, and 51% respectively. Relative to women with triple disadvantage, the odds of contact coverage of 4ANC visits was more than five-fold higher (Adjusted Odds Ratio (aOR) = 5.51; 95% CI: 2.85, 10.64) among women with triple forms of advantages (literate and advantaged ethnicity and higher wealth status). Women with triple advantages were seven-fold more likely to give birth in a health institution (aOR = 7.32; 95% CI: 3.66, 14.63). They were also four times more likely (aOR = 4.18; 95% CI: 2.40, 7.28) to receive PNC visit compared to their triple disadvantaged counterparts. Conclusions The contact coverage of routine MNH visits was low among women with social disadvantages and lowest among women with multiple forms of socioeconomic disadvantages. Tracking health service coverage among women with multiple forms of (dis) advantage can provide crucial information for designing contextual and targeted approaches to actions towards universal coverage of MNH services and improving health equity.

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