Knowledge Sharing for Maternal Health at a Public Hospital in South Africa

2021 ◽  
Author(s):  
Nkateko Nikiwe Nkunkwane ◽  
MC Fombad
Keyword(s):  
South Africa ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Knowledge Sharing ◽  
Public Hospital ◽  
Well Being ◽  
The Body ◽  
Maternal Deaths ◽  
Referral Hospitals ◽  
Convenience Sampling

Purpose: This paper investigates knowledge sharing for maternal health in one of the major public referral hospitals in South Africa–the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). Poor knowledge on maternal health continues to present a global challenge, particularly in developing countries where maternal mortality remains very high. Design/methodology/approach: A qualitative study and case study design were conducted to obtain an in-depth understanding of knowledge sharing for maternal health in one of the major public referral hospitals in South Africa. Convenience sampling of 35 pregnant women was undertaken. In-depth face-to-face interviews were employed to the point of saturation. Findings: The findings revealed elementary knowledge sharing for maternal health and several challenges to knowledge sharing. Limitations: This paper focuses on knowledge sharing at the antenatal care unit. Although effective knowledge sharing during antenatal phase may enhance post-natal care, it will have been beneficial to also understand the post-natal perspective of knowledge sharing. Furthermore, issues of representativeness may result from the use of convenience sampling. However, the purpose of this study is not to generalise the results but to provide an in-depth understanding of knowledge sharing for maternal health in a public hospital in South Africa and suggests a dynamic interactive strategy to enhance knowledge sharing that may effectively improve maternal health. Practical implication: Strategies for knowledge sharing for maternal health were established. The paper concluded that increasing knowledge sharing on safe motherhood practices would translate into safer pregnancy outcomes and would subsequently lead to lower maternal mortality. Knowledge sharing is critical in improving maternal health in a developing country like South Africa, where maternal deaths during pregnancy, childbirth and the puerperium remain a significant public health issue. Goal 3 of the 17 Sustainable Development Goals (SDGs) developed in 2015 seeks to promote good health and well-being and to reduce the global maternal mortality ratio (MMR) to fewer than 70 maternal deaths per 100,000 live births by 2030. Knowledge sharing is crucial in reducing the MMR. Originality/value: Studies conducted on knowledge sharing in the health sector have focused mainly on health professionals and the use of technology for mobile health. This paper adds to the body of knowledge-on-knowledge management and healthcare services, with specific focus on knowledge sharing and maternal care. Knowledge sharing for maternal health will reduce pregnancy, childbirth and motherhood-related health risks.

scholarly journals The reconstitution of African women's spiritualities in the context of the Amazwi Abesifazane (Voices of Women) project in KwaZulu-Natal (1998-2005)

2006 ◽  
Author(s):  
◽  
Bernice Stott
Keyword(s):  
South Africa ◽  
Narrative Therapy ◽  
Well Being ◽  
National Archive ◽  
The Body ◽  
Government Support ◽  
African Women ◽  
Primary Data ◽  
Therapeutic Effects ◽  
Kwazulu Natal

This study will investigate and critically evaluate the reconstitution of African women’s spiritualities in the context of the Amazwi Abesifazane project. This project forms part of the endeavours of Create Africa South, a Non Governmental Organisation situated in Durban, KwaZulu-Natal, which was initiated by the artist Andries Botha. It encourages women, post trauma, to ‘re-member’ themselves by creating memory cloths of embroidery and appliqué reflecting on their experiences in pre- and post-apartheid South Africa. This interdisciplinary study theorises that it is an archive that speaks about African women resisting destructive forces and reconstituting their spiritualities through the therapeutic effects of creativity. The study will not include research into the many other activities undertaken by Create Africa South. Rupture is implied in the use of the word ‘reconstitution’. Reconstitution encompasses the act of constituting again the character of the body, mind and spirit as regards health, strength and well-being of the women (McIntosh, 1970:261). In this study, spirituality is defined as the way in which the women in the Amazwi Abesifazane project reflect upon and live out their belief in God. The power of storytelling is examined from the perspectives of narratology, narrative therapy, sewing and orality/literary studies as resources for the women’s reclamation of their lives. Defining feminisms in South Africa is problematised by issues of race, class and culture. In a context of poverty, everyday survivalist strategies are the diverse forms of resistance seen in the Amazwi Abesifazane project. The women’s stories, cloths and interviews are triangulated as primary data. They are examples of the rich art of resistance against despair and are located in a paradigm of hope. In conclusion, I strongly call for government support in declaring the project a national archive. The multidimensional mediums of the Amazwi Abesifazane/ UbuMama projects nurture the women’s creativity and revitalise their spiritualities towards personal and national transformation.

Chronic diseases raise global risks to maternal health

2015 ◽  
Keyword(s):  
Maternal Health ◽  
Maternal Mortality ◽  
Millennium Development Goals ◽  
Significant Loss ◽  
Maternal Deaths ◽  
Content Type ◽  
Global Rate ◽  
Development Goals ◽  
Developed World ◽  
Public Health Provision

Subject Progress in ending Maternal Mortality Rates globally. Significance The global rate of maternal deaths since 1990 has dropped significantly. However, with the Millennium Development Goals (MDG) expiring this year, only 16 countries are on track to achieve MDG 5: to reduce the maternal mortality rate (MMR) by 75%. Reduction rates in developing countries have also slowed, while rates in the developed world are rising. Such uneven progress in maternal health suggests that the current models for public health provision are inadequate. Impacts The economies of countries with high MMR are disrupted by the significant loss of productive young women. The loss of the mother stilts the development of surviving children, perpetuating cycles of poverty. Health systems that fail to provide maternity care will also be profoundly crippled in their capacity to serve the wider population.

scholarly journals Incidence of maternal near-miss in Kenya in 2018: findings from a nationally representative cross-sectional study in 54 referral hospitals

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Onikepe Owolabi ◽  
Taylor Riley ◽  
Kenneth Juma ◽  
Michael Mutua ◽  
Zoe H. Pleasure ◽  
...  
Keyword(s):  
Maternal Health ◽  
Maternal Mortality ◽  
Obstetric Care ◽  
Near Miss ◽  
World Health ◽  
Maternal Near Miss ◽  
Live Births ◽  
Management Of Complications ◽  
Referral Hospitals ◽  
Nationally Representative

Abstract Although the Kenyan government has made efforts to invest in maternal health over the past 15 years, there is no evidence of decline in maternal mortality. To provide necessary evidence to inform maternal health care provision, we conducted a nationally representative study to describe the incidence and causes of maternal near-miss (MNM), and the quality of obstetric care in referral hospitals in Kenya. We collected data from 54 referral hospitals in 27 counties. Individuals admitted with potentially life-threatening conditions (using World Health Organization criteria) in pregnancy, childbirth or puerperium over a three month study period were eligible for inclusion in our study. All cases of severe maternal outcome (SMO, MNM cases and deaths) were prospectively identified, and after consent, included in the study. The national annual incidence of MNM was 7.2 per 1,000 live births and the intra-hospital maternal mortality ratio was 36.2 per 100,000 live births. The major causes of SMOs were postpartum haemorrhage and severe pre-eclampsia/eclampsia. However, only 77% of women with severe preeclampsia/eclampsia received magnesium sulphate and 67% with antepartum haemorrhage who needed blood received it. To reduce the burden of SMOs in Kenya, there is need for timely management of complications and improved access to essential emergency obstetric care interventions.

Factors Cause of Maternal Death in Timor-Leste

2017 ◽  
Vol 3 (2) ◽  
pp. 30
Author(s):  
Feliciano Pinto ◽  
I Ketut Suwiyoga ◽  
I Gde Raka Widiana ◽  
I Wayan Putu Sutirta Yasa
Keyword(s):  
Health Status ◽  
Maternal Health ◽  
Health Behaviors ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Good Health ◽  
Birth Spacing ◽  
Maternal Deaths ◽  
Live Births ◽  
Timor Leste

Maternal mortality was an indicator of basic health services for mothers or women of reproductive age of a country and was one of the eight Millennium Development Goals (MDGs). Factors that affect maternal mortality, among others: medical factors, non-medical factors, and health care system factors. Meanwhile, WHO (2010) reported that the cause of maternal mortality in the world is 25% of bleeding, 15% of infection/sepsis, 12% eclampsia, 13% of abortions are unsafe, 8% obstructed and ectopic pregnancy, 8% embolisms and other related issues with anesthetic problems. WHO (2010) has determined that the maternal mortality rate (MMR) in 40 countries ≥ 300 / 100,000 live births including República Democrática de Timor-Leste at 557 / 100,000 live births. Objective: This study aimed to determine the relationship between the variables of age, parity, spacing pregnancies, health behavior, and health status of mothers with maternal deaths. Methods: The study design was a cross-sectional study with a sample of 298 pregnant women in 13 districts throughout Timor-Leste. Results: Maternal deaths are caused by independent variables simultaneously and the remaining 28.0% were prescribed other factors. Low maternal health behaviors that lead to maternal death by 40.348 times higher compared with mothers who have good health behaviors. The health status of low maternal causes of maternal mortality by 23.340 times higher than mothers who have a good health status. Birth spacing ˂ two years caused the death of the mother of 16.715 times higher than women with birth spacing ˃ 2 years. Maternal age and parity variables showed no significant effect. Conclusion: There was a significant relationship between behavioral maternal health, maternal health, birth spacing with maternal mortality while age and parity are not related.

Influence of Social and Cultural Practices on Maternal Mortality: A Qualitative Study from South Punjab, Pakistan

2020 ◽  
Author(s):  
Sonia Omer ◽  
Rubeena Zakar ◽  
Muhammad Zakria Zakar ◽  
Florian Fischer
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Maternal Care ◽  
Cultural Practices ◽  
Cultural Factors ◽  
Maternal Health Care ◽  
High Rate ◽  
Maternal Deaths ◽  
Social And Cultural Factors

Abstract Background: A disproportionate high rate of maternal deaths are reported in developing and underdeveloped regions of the world. Much is associated with social and cultural factors which are barriers for women to utilise appropriate maternal health care. A huge body of research is available on maternal mortality in developing countries. Nevertheless, there is paucity of literature on socio-cultural factors leading to maternal mortality within the context of the Three Delay Model. The current study aims to explore socio-cultural factors leading to a delay in seeking care in maternal healthcare in South Punjab, Pakistan. Methods: We used a qualitative method and performed three types of data collection with different target groups: i) 60 key informative interviews with gynaecologists, ii) four focus group discussions with Lady Health Workers (LHWs), and iii) ten case studies among family members of deceased mothers. The study was conducted in Dear Ghazi Khan, situated at South Punjab, Pakistan. Data was analysed with the help of thematic analysis.Results: The study identified that delay in seeking care – and its potentially following maternal mortality – is more likely to occur due to certain social and cultural factors in Pakistan. Poor socioeconomic status, limited knowledge on maternal care, and financial constraints of rural people were the main barriers in seeking care. Low status of women and male domination keeps women less empowered. The preference of traditional birth attendants results into maternal deaths. In addition to that, early marriages and lack of family planning as deeply entrenched in cultural values, religion and traditions – e.g. the influence of spiritual healers – prevented young girls to obtain maternal health care.Conclusion: The situation of maternal mortality is highly alarming in Pakistan. The uphill task of reducing deaths among pregnant women is deeply rooted in addressing certain socio-cultural practices, which are constraints for women seeking maternal care. The focus on reduction of poverty and enhancement of decision-making power is essential for approaching the right of medical care.

scholarly journals Retrospective analysis of maternal mortality: a paradigm shift from 2010 to 2020

2021 ◽  
Vol 10 (8) ◽  
pp. 3079
Author(s):  
Sujani Kempaiah ◽  
Urvashi . ◽  
Mamatha . ◽  
Jessica Celina Fernandes ◽  
Gayatri Devi Sivasambu ◽  
...  
Keyword(s):  
Health Services ◽  
Maternal Mortality ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Well Being ◽  
Hospital Data ◽  
College Hospital ◽  
Maternal Deaths ◽  
Diagnosis And Management ◽  
Hypertensive Disorders

Background: Maternal mortality is attributed usually to complications that generally occur during or around labour and these are mostly preventable through proper understanding, diagnosis and management of labour complications. The quality of health services women receive during pregnancy, intranatal and postnatal periods are crucial for the survival and well-being of the mother and her newborn baby. The objective was to analyse the changing trends in maternal mortality occurring over a decade, to assess factors associated with maternal mortality and propose effective interventions in preventing such mortality.Methods: It was a retrospective study to analyse maternal mortality between January 2010 and January 2020 in Ramaiah medical college hospital. Data was collected the institutional medical and delivery records and patient details regarding obstetric history, pre-existing comorbidities, cause of death, interventions done was noted and review of maternal mortality was done.Results: The maternal mortality in the present study was 432.73/1 lakh live births. There were 57 maternal deaths in the study period. Most deaths occurred in the 20-25 age group. 42.10% of deaths occurred ninety six hours after admission. Sepsis (42.1%), hypertensive disorders (12.30%) and haemorrhage (10.5%) are the most common direct causes of maternal death. Post-operative and post abortal sepsis, ARDS, cardiogenic shock, pulmonary embolism and AFLP are the other direct causes. Hypertensive disorders (9.64%) and haemorrhage (19.5) is the two leading indirect causes of maternal deaths.Conclusions: Maternal health services should move beyond the focus on emergency obstetric care, to a broader approach that encompasses preventive and early interventions and integration with existing services. Most of the maternal deaths can be prevented if the high risk antenatal women are identified earlier and referred to the tertiary centre earlier for diagnosis and management. 

scholarly journals Maternal Mortality Rate at East Ogan Komering Ulu (East OKU) Regional Public Hospital Over a Four Year Period: Trends, Its Associated Factors and Neonatal Outcome

2019 ◽  
pp. 97-100
Author(s):  
Cindy Kesty ◽  
Hendra S Saputra
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Associated Factors ◽  
Public Hospital ◽  
Neonatal Outcome ◽  
Downward Trend ◽  
Hypertensive Disorder ◽  
Childbearing Age ◽  
Maternal Deaths ◽  
Maternal Mortality Rate

Objective: To determine the MMR trends, its associated factors, and neonatal outcome at East OKU Regional Public Hospital from 2013 until 2016. Methods: This descriptive study was performed from January 2013 until December 2016 in maternity ward and Intensive Care Unit (ICU) of East OKU Regional Public Hospital, South Sumatera. Data was collected from medical records. There were 17 maternal deaths, but 1 data was excluded due to lack of data. Results: We recorded 2,191 pregnancies and 17 maternal deaths. Over 4 years, the lowest MMR occurred in 2013 (229/100,000) and achieved its peak in 2014 (1,306/100,000). Then, MMR followed downward trend dropping from 1,087/100,000 in 2015 until 588/100,000 in 2016. Most of deceased were childbearing age women (50.0%), multigravida (62.5%), but nulliparous (50.0%), and aterm (87.5%). The major etiology of maternal deaths were hypertensive disorder (37.5%), followed by hypertensive disorder + hemorrhage and hypertensive disorder + infection in the same proportion. MMR were higher in inborn cases (87.5%), born via C-section (87.5%), and treated for less than 48 hours (93.75%). Alive neonatal were born in most cases (62.5%). Conclusion: MMR trends in our hospital were fluctuating with a downward trend, but still much higher than the MDGs target in 2015 (102/100,000). Hypertensive disorder plays significant role in maternal deaths. In addition, most of neonates were born alive. We hope that this study can be a feedback for hospital to do maternal and perinatal audit. Keywords: Factors, Maternal mortality rate, Neonatal outcome, Regional public hospital, Trends     Tujuan: Untuk menentukan pola, faktor yang berkaitan, dan luaran neonatus di RSUD OKU Timur dari 2013 hingga 2016. Metode: Studi deskriptif dilakukan dari Januari 2013 hingga Desember 2016 di bangsal kebidanan dan unit perawatan intensif RSUD OKU Timur, Sumatera Selatan. Data dikumpulkan dari rekam medik. Terdapat 17 kematian ibu, tetapi 1 data dieksklusi karena data yang kurang lengkap. Hasil: Terdapat 2.191 kehamilan, dan 17 kematian ibu. Selama 4 tahun, AKI terendah terjadi pada 2013 (229/100.000) dan mencapai puncaknya pada 2014 (1.306/100.000). Kemudian, AKI mengalami penurunan dari 1.087/100.000 pada 2015 hingga 588/100.000 pada 2016. Mayoritas sampel berusia reproduktif (50,0%), multigravida (62,5%) dan nulipara (50,0%), serta aterm (87,5%). Mayoritas kematian ibu disebabkan oleh hipertensi dalam kehamilan (HDK) (37,5%), diikuti oleh HDK + perdarahan dan HDK + infeksi dalam jumlah yang sama. AKI lebih tinggi pada ibu yang melahirkan di RS (87,5%), melahirkan melalui sectio caesaria (87,5%), dan dirawat selama kurang dari 48 jam (93,75%). Mayoritas neonatus dilahirkan hidup (62,5%). Kesimpulan: Pola AKI di RSUD berfluktuasi dengan pola menurun, tetapi masih jauh lebih tinggi dari target MDGs pada tahun 2015 (102/100,000). Hipertensi dalam kehamilan berperan signifikan terhadap kematian ibu. Mayoritas neonatus dilahirkan hidup. Studi ini diharapkan dapat menjadi masukan bagi rumah sakit untuk melakukan audit maternal dan perinatal. Kata kunci: Angka kematian ibu, Faktor, Luaran neonatus, Pola, Rumah sakit umum daerah

Non-citizens and maternal mortality in Botswana: a rights perspective

2014 ◽  
Vol 10 (4) ◽  
pp. 220-230
Author(s):  
Keitshokile Dintle Mogobe ◽  
Sunanda Ray ◽  
Farai Madzimbamuto ◽  
Mpho Motana ◽  
Doreen Ramogola-Masire ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Maternal Mortality ◽  
Health Professionals ◽  
Maternal Health Services ◽  
Free Access ◽  
Maternal Deaths ◽  
Case Record ◽  
Content Type ◽  
Obstetric Emergencies

Purpose – The purpose of this paper is to identify organisational, technical and individual factors leading to maternal deaths in non-citizen women in Botswana. Design/methodology/approach – A sub-analysis was conducted comparing non-citizen women to citizens in a case record review of maternal deaths in 2010. Feedback on the results to health professionals was provided and their comments were noted. Findings – In total, 19.6 per cent of 56 case notes reviewed to establish contributory factors to maternal deaths were in non-citizens. This is lower than health professionals perceptions that most maternal deaths are in non-citizens. Non-citizens were significantly less likely to have been tested for HIV and less likely to have received antenatal care, so did not receive interventions to prevent transmission of HIV to their infants or anti-retroviral therapy. They were more likely than citizens to have miscarried or delivered before 28 weeks gestational age at death. Delays in seeking health care were a major contributory factor to death. Research limitations/implications – Incomplete record keeping and missing details, with 30 per cent of the notes of maternal deaths missing, a common problem with retrospective case-note studies. Practical implications – Botswana is unlikely to meet Millennium Development Goal five target to reduce the maternal mortality ratio by 75 per cent. To make progress non-citizens must be given the same rights to access maternal health services as citizens. Rationing healthcare for non-citizens is a false economy since treatment of subsequent obstetric emergencies in this group is expensive. Originality/value – Discrimination against non-citizen women in Botswana, by denying them free access to maternal health services, extends into loss of life because of delays in seeking healthcare especially for obstetric emergencies.

Oxford Textbook of Global Health of Women, Newborns, Children, and Adolescents

2018 ◽  
Keyword(s):  
Maternal Health ◽  
Maternal Mortality ◽  
Maternal Morbidity ◽  
Well Being ◽  
Reproductive Age ◽  
Middle Income ◽  
Pregnancy And Childbirth ◽  
Middle Income Countries ◽  
Development Goals ◽  
Low And Middle Income

Maternal morbidity describes complications during pregnancy and childbirth that are a leading cause of death, disability, and ill health among women of reproductive age, especially in low and middle-income countries. With the introduction of the new Sustainable Development Goals, the scope of global maternal health targets has been expanded, moving from a focus on preventing maternal mortality to formulating targets and emphasising the importance of maternal health and well-being. This book introduces the new concept of maternal morbidity, suggests how this relates to maternal mortality, summarises what is known about the burden of maternal morbidity globally and what interventions and research are needed to improve maternal health during and after pregnancy, with an emphasis on the context of low and middle-income countries.

scholarly journals In the era of humanitarian crisis, young women continue to die in childbirth in Mali

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Pierre Coulibaly ◽  
Clémence Schantz ◽  
Brehima Traoré ◽  
Nanko S. Bagayoko ◽  
Abdoulaye Traoré ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Central Region ◽  
Maternal Health Services ◽  
Blood Collection ◽  
Health Coverage ◽  
Humanitarian Crisis ◽  
Maternal Deaths ◽  
Safe Blood

AbstractMaternal mortality occurs mostly in contexts of poverty and health system collapse. Mali has a very high maternal mortality rate and this extremely high mortality rate is due in part to longstanding constraints in maternal health services. The central region has been particularly affected by the humanitarian crisis in recent years, and maternal health has been aggravated by the conflict. Sominé Dolo Hospital is located in Mopti, central region. In the last decade, a high number of pregnant or delivering women have died in this hospital.We conducted a retrospective and exhaustive study of maternal deaths occurring in Mopti hospital. Between 2007 and 2019, 420 women died, with an average of 32 deaths per year. The years 2014–2015 and the last 2 years have been particularly deadly, with 40 and 50 deaths in 2018 and 2019, respectively. The main causes were hypertensive disorders/eclampsia and haemorrhage. 80% of these women’s deaths were preventable. Two major explanations result in these maternal deaths in Sominé Dolo’s hospital: first, a lack of accessible and safe blood, and second, the absence of a reference and evacuation referral system, all of which are aggravated by security issues in and around Mopti.Access to quality hospital care is in dire need in the Mopti region. There is an urgent need for a safe blood collection system and free of charge for pregnant women. We also strongly recommend that the referral/evacuation system be reinvigorated, and that universal health coverage be strengthened.

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