scholarly journals Primary health care among rural pregnant women in China: achievements and challenges in maternal mortality ratio

Author(s):  
Le Yang ◽  
Hongman Wang

Abstract Background: The maternal mortality ratio (MMR) is not only an important indicator of maternal and infant safety, but also a sign of the development of economy, education, and medical care in a country. In the last 60 years, the Chinese government has implemented various strategies and policies to reduce the MMR, especially in the rural areas. Aim: This study aimed to discuss the strategies developed by the Chinese government, showing the successful experience of Chinese intervention programs and highlighting the challenges to the government in the context of current economic and social status. Method: This study probed into the Chinese government’s efforts and achievements in the MMR reducing by reviewing the relevant health policies, extracting the data from China Health Statistics Yearbook of 2015, analyzing the reduction of maternal death in rural areas and the major causes from 1991 to 2015, comparing the MMR trend in urban and rural areas, and discussing the changes of the situation in China. Finding: Although it seems that Chinese government’s efforts have brought evangel to the rural pregnant women and significantly reduced rural maternal mortality, the government still needs to develop more equitable and flexible primary health care policies to narrow the imbalance in health resource allocation and pay more attention to the health care for the rural-to-urban migration in China.

2018 ◽  
Vol 28 (1) ◽  
Author(s):  
Kofi P. Quan-Baffour

Ghana was colonised in 1482 when Europeans, accompanied by a number of missionaries, arrived at a small coastal town called Edina in the present day Central Region. Colonialism brought with it Western education, religious values, and medical care. The missionaries opened schools, clinics, and hospitals in several parts of the country but these facilities were not available in many remote areas. Before colonisation Ghanaians made medicines from plants to cure sicknesses and diseases. Although the missionaries and the colonisers regarded African medicine as fetish and attempted to annihilate it—Ghanaians—especially those living in areas without hospital facilities, continued to rely on local medicines for curing illnesses. Medicinal plants such as the neem tree, lemon, moringa, ginger etc., are used as concoctions to alleviate the symptoms of malaria, headaches, boils, diabetes, high blood pressure, and stomach pains. When the government recently introduced primary health care, indigenous medicines became a de facto partner in health care delivery, particularly in the rural areas where hospitals and medical facilities are inadequate. This study employed qualitative methods to explore the value of indigenous medicinal plants in the country’s primary health care programme. The study found that indigenous medicine plays an important role in health care delivery because it is accessible and affordable. Even people who visit hospitals still use indigenous medicines side by side with the pharmaceutical drugs offered by medical practitioners.


2017 ◽  
Vol 18 (04) ◽  
pp. 398-403 ◽  
Author(s):  
Jing-Min Cheng ◽  
Yong-Xu Yuan ◽  
Wei Lu ◽  
Le Yang

Background: Good primary health care can enhance national health status at relatively low cost. The barefoot doctor model in China was once considered to have been a successful health care policy. It was a model which was followed by other low-developed or developing countries. In recent decades, the Chinese government promulgated a number of new policies and health reforms to improve its health care system. Aim: This paper aimed to highlight the great significance of primary health care and appeal to the policymakers to change the priority to primary health care in order to be able to guarantee universal health care for the whole nation at least at primary care level. Method: This study discussed Chinese primary health care by reviewing its history and development. Finding: Chinese government’s efforts do not seem to be leading to a completely successful outcome for all the people of China as a result of the substantial imbalance of investments between tertiary level hospitals and grass-root level health care institutions. The government appears to have neglected the importance of primary health care in the implementation of health systems and resources.


2018 ◽  
Vol 7 (4) ◽  
pp. 248
Author(s):  
Dini Rima Fadilah ◽  
Shrimarti Rukmini Devy

<span lang="EN-US">The death of pregnant women is still the world's attention in the field of health. The SDG's indicator provides one of the goals in the health field. The target to be achieved is a global maternal mortality ratio of less than 70/100,000 live births by 2030. According to WHO, preeclampsia is one of the leading causes of maternal death in the world, including Indonesia. East Java Province with the highest ranking in Indonesia. One of the cities in East Java which is the leading contributor to preeclampsia is Surabaya with 16 cases in 2016. The government carries out the treatment to reduce maternal mortality due to preeclampsia through antenatal care. This study aimed to analyze antenatal care visits for early detection of preeclampsia. The method in this research is qualitative research method with data retrieval technique using in-depth interview. Based on the results of research antenatal care visits have an effect on early detection of preeclampsia. Pregnant women who regularly make antenatal visits can prevent possible dangers of pregnancy as early as possible. So the maternal mortality rate (MMR) due to pre-eclampsia can be decreased.</span>


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nina Mendez-Dominguez ◽  
Karen Santos-Zaldívar ◽  
Salvador Gomez-Carro ◽  
Sudip Datta-Banik ◽  
Genny Carrillo

Abstract Background In Mexico, the COVID-19 pandemic led to preventative measures such as confinement and social interaction limitations that paradoxically may have aggravated healthcare access disparities for pregnant women and accentuated health system weaknesses addressing high-risk patients’ pregnancies. Our objective is to estimate the maternal mortality ratio in 1 year and analyze the clinical course of pregnant women hospitalized due to acute respiratory distress syndrome and COVID-19. Methods A retrospective surveillance study of the national maternal mortality was performed from February 2020–February 2021 in Mexico related to COVID-19 cases in pregnant women, including their outcomes. Comparisons were made between patients who died and those who survived to identify prognostic factors and underlying health conditions distribution. Results Maternal Mortality Ratio increased by 56.8% in the studied period, confirmed COVID-19 was the cause of 22.93% of cases. Additionally, unconfirmed cases represented 4.5% of all maternal deaths. Among hospitalized pregnant women with Acute Respiratory Distress Syndrome consistent with COVID-19, smoking and cardiovascular diseases were more common among patients who faced a fatal outcome. They were also more common in the age group of < 19 or > 38. In addition, pneumonia was associated with asthma and immune impairment, while diabetes and increased BMI increased the odds for death (Odds Ratio 2.30 and 1.70, respectively). Conclusions Maternal Mortality Ratio in Mexico increased over 60% in 1 year during the pandemic; COVID-19 was linked to 25.4% of maternal deaths in the studied period. Lethality among pregnant women with a diagnosis of COVID-19 was 2.8%, and while asthma and immune impairment increased propensity for developing pneumonia, obesity and diabetes increased the odds for in-hospital death. Measures are needed to improve access to coordinated well-organized healthcare to reduce maternal deaths related to COVID-19 and pandemic collateral effects.


2021 ◽  
Author(s):  
Huanhuan Jia ◽  
Hairui Jiang ◽  
Jianxing Yu ◽  
Jingru Zhang ◽  
Zhou Zheng ◽  
...  

Abstract Background: The serious shortage of primary health care (PHC) providers is a common issue in the health reforms worldwide, including in China. The government of China have proposed that encouraging and guiding qualified medical personnel to work in primary medical and health care institutions (PMHCIs) is an effective way to improve the overall quality and efficiency of PHC, but it has not produced good results. The problem of insufficient human resources of PHC has not been substantially ameliorated.Methods: Based on implicit theory and lexical approach, pre-investigation was conducted to collect the items that influence the medical personnel to seek employment at PMHCIs from the perspective of guided objects. Through a three-phase investigation of 1,160 doctors in 29 public hospitals in 9 cities, the items were categorized, and a structural equation model was established and verified to explore the interrelationship of influencing factors.Results: A total of 5 factors were rotated, including Sense of Gain (SG), Internal Organization Development (IOD), Remuneration and Development (RD), Condition of the City Where the PMHCI Is Located (CCPL), Job Responsibilities (JR) and Family Support (FS). The results of the model showed that IOD, RD, JR and FS had a significantly positive effect on the SG, whereas CCPL had no significant direct effect. In addition, the FS, RD and JR significantly mediated the relationship between the internal and external environment of the institution and the willing of medical personnel to seek employment at PMHCIs. The values of fit index indicated an acceptable-fitting model.Conclusion: Family, remuneration, individual development, and job responsibility are closely related with the willingness of medical personnel to seek employment at PMHCIs, and the internal and external environment of PMHCIs is also an important factor. Based on this, targeted measures can be proposed to promote the development of PHC providers.


Author(s):  
Darshna M. Patel ◽  
Mahesh M. Patel ◽  
Vandita K. Salat

Background: According to the WHO, 80 of maternal deaths in developing countries are due to direct maternal causes such as haemorrhage, hypertensive disorders and sepsis. These deaths are largely preventable. Maternal mortality ratio (MMR) in India is 167/100,000 live births.Methods: This retrospective observational study was conducted at GMERS, Valsad. Data regarding maternal deaths from January 2016 to December 2017 were collected and analyzed with respect to epidemiological parameters. The number of live births in the same period was obtained from the labour ward ragister. Maternal mortality rate and Mean maternal mortality ratio for the study period was calculated.Results: The mean Maternal mortality rate in the study period was 413.3/100,000 births. The maternal mortality ratio (MMR) in India is 167/100,000 live births. More than half of maternal deaths were reported in multiparous patients. More maternal deaths were observed in women from rural areas (67.3%), unbooked patients (73.3%) and illiterate women (65.3%). Thirty six (69.3%) maternal death occurred during postpartum period. Most common delay was first delay (60.0%) followed by second delay (40.0%). Postpartum haemorrhage (28.8%), preeclampsia (17.3%), sepsis (13.46%) were the major direct causes of maternal deaths. Indirect causes accounted for one third of maternal deaths in our study. Anemia, hepatitis and heart disease were responsible for 13.4%, 5.7%, and 1.9% of maternal deaths, respectively.Conclusions: Majority of maternal deaths are observed in patients from rural areas, unbooked, and illiterate patients. Hemorrhage, eclampsia and sepsis are leading causes of maternal deaths. Most of these maternal deaths are preventable if patients are given appropriate treatment at periphery and timely referred to higher centers.


2021 ◽  
Author(s):  
Yunyun Yan ◽  
Teng-yang Fan ◽  
Yan-ling Zheng ◽  
Hai-qin Yang ◽  
Tian-shu Li ◽  
...  

Abstract Background In fulfilling the COVID-19 containment, primary health care (PHC) facilities in China played an important role. We sought to investigate the exact tasks performed at the PHC facilities and the processes of COVID-19 prevention and control.Methods Semi-structured face-to-face interviews for primary care physicians (PCPs) and a simple survey for residents were conducted in the field survey. Based-on purposive stratified sampling, 32 PCPs were selected from 22 PHC facilities in Wuhan as a high-risk city, in Shanghai as medium-risk city and in Zunyi as low-risk city. In the field survey, semi-structured face-to-face interviews were conducted with PCPs to summarize the tasks of COVID-19 prevention and control at the PHC facilities. A simple survey was used to investigate the local residents’ awareness about COVID-19 prevention and control.Results In pre-outbreak period, the PHC facilities mainly engaged in storing medical supplies; in out-break period, they were responsible for screening, transferring, quarantine and treatment; in regular prevention and control period, attention was given to the employees and items of cold-chain & fresh food markets, etc. In Wuhan, PHC facilities focused on graded diagnoses and treatments of patients; in Shanghai, they were mainly engaged in at-home/centralized quarantine; in Zunyi, they focused on the screening of high-risk individuals. In urban areas, COVID-19 were more likely to be transmitted; in urban-rural areas, it was difficult to perform screening on the migrant populations; in rural areas, the risk was much lower. The community residents had satisfactory compliance with the preventive measures.Conclusion We identified differences in the prevention and control tasks performed at the PHC facilities in China. During the different phases of the pandemic, the tasks were adjusted depending on the gradually comprehensive understanding of COVID-19. Among the cities at different risk levels, screening, quarantine, transferring or treatment was chosen to be a priority accordingly. Located in different intra-city geographic locations at different risk levels, the PHC facilities conducted their own tasks accordingly. Additionally, compliance on the part of the local community residents could not be overemphasized in COVID-19 prevention and control.


2020 ◽  
Vol 13 (1) ◽  
pp. 569-575
Author(s):  
Lucia Drigo ◽  
Masane Luvhengo ◽  
Rachel T. Lebese ◽  
Lufuno Makhado

Background: Pregnant woman’s personal experience of antenatal care services can either be positive or negative; however, knowledge and experience appear to be of paramount importance in shaping their attitudes towards any healthcare-related services. This implies that women's experience of antenatal care services may affect their decision for seeking antenatal care in their present pregnancy, which can lead them to delay seeking care. Purpose: This study sought to explore the attitudes of pregnant women towards antenatal care services provided in primary health care facilities of Mbombela Municipality, Mpumalanga Province, South Africa. Methods: A qualitative exploratory descriptive study design was used for this study. Purposive sampling technique was used to sample pregnant women who fail to attend antenatal services as expected. Data were collected through face to face unstructured in-depth interview. A total of eighteen pregnant women participated in the study until data saturation. Data were analysed using Tech’s method of analysis. Results: Results revealed the following theme and sub-themes: Attitudes of pregnant women related to individual perceptions, perceived barriers to utilizing antenatal care services,’ attitudes of healthcare providers, long waiting times in healthcare facilities, lack privacy and confidentiality in healthcare facilities and attitudes of pregnant women related to attendance of antenatal services. Conclusion: Attitudes of pregnant women about antenatal care are shaped by their knowledge and previous encounters with the health care services that they had previously received. It is therefore important to provide women-friendly services. It is recommended that health education regarding the importance of antenatal care services must be given to all women daily in the waiting areas of each primary health care facilities, thus, the healthcare providers should promote the active participation of pregnant women during the health education sessions and provide opportunities to ask questions.


2021 ◽  
Vol 15 (2) ◽  
pp. 168
Author(s):  
Meimi Laillah ◽  
Ridwan Manda Putra ◽  
Suyanto Suyanto

TTuberculosis (TB) is a chronic infectious disease caused by the Mycobacterium tuberculosis (MTB) which affects the lungs and other organ., Indonesia is the third highest after India and China and Indonesia’s top ten causes of death in Indonesia. The purposeofthis study wastodeterminestrategycontrolof the TB Program in Pekanbaru City. Thisstudyisresearchwith SWOT analysisandsurveyanddirectinterviews in thefield,and the studyisgoing onJanuary-February 2021 at Pekanbaru City Primary Health Care, Tenayan Raya and Simpang Tiga PrimaryHealth Care.interview and survey with a total sampling method of 84 samples. The study’s resultsfrom the government policy involved that supporting the TB program in   Pekanbaru cityisrespectable. At thesametime, fromthecommunity in thefield, there are stillpeoplewhodo not understand TB disease, forexample, theincidenceof TB disease, mode oftransmission, andthedurationoftreatmentandprevention. Suggested in controllingthe program TB disease, it is necessary to provide education and explanation to sufferers and the surrounding community


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