scholarly journals Indirect maternal deaths: UK and global perspectives

2017 ◽  
Vol 10 (1) ◽  
pp. 10-15 ◽  
Author(s):  
Manisha Nair ◽  
Catherine Nelson-Piercy ◽  
Marian Knight
Keyword(s):  
Communicable Diseases ◽  
Reproductive Age ◽  
Steady Increase ◽  
Access To Health Services ◽  
Maternal Deaths ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Delay In Diagnosis ◽  
Middle Income Countries ◽  
The Uk

Indirect maternal deaths outnumber direct deaths due to obstetric causes in many high-income countries, and there has been a significant increase in the proportion of maternal deaths due to indirect medical causes in low- to middle-income countries. This review presents a detailed analysis of indirect maternal deaths in the UK and a perspective on the causes and trends in indirect maternal deaths and issues related to care in low- to middle-income countries. There has been no significant decrease in the rate of indirect maternal deaths in the UK since 2003. In 2011–2013, 68% of all maternal deaths were due to indirect causes, and cardiac disease was the single largest cause. The major issues identified in care of women who died from an indirect cause was a lack of clarity about which medical professional should take responsibility for care and overall management. Under-reporting and misclassification result in underestimation of the rate of indirect maternal deaths in low- to middle-income countries. Causes of indirect death include a range of communicable diseases, non-communicable diseases and nutritional disorders. There has been evidence of a shift in incidence from direct to indirect maternal deaths in many low- to middle-income countries due to an increase in non-communicable diseases among women in the reproductive age. The gaps in care identified include poor access to health services, lack of healthcare providers, delay in diagnosis or misdiagnosis and inadequate follow-up during the postnatal period. Irrespective of the significant gains made in reducing maternal mortality in many countries worldwide, there is evidence of a steady increase in the rate of indirect deaths due to pre-existing medical conditions. This heightens the need for research to generate evidence about the risk factors, management and outcomes of specific medical comorbidities during pregnancy in order to provide appropriate evidence-based multidisciplinary care across the entire pathway: pre-pregnancy, during pregnancy and delivery, and postpartum.

scholarly journals A comprehensive capacity assessment tool for non-communicable diseases in low- to middle-income countries: development and results of pilot testing

2016 ◽  
Vol 25 (1) ◽  
pp. 43-53 ◽  
Author(s):  
Isabel Garcia de Quevedo ◽  
Felipe Lobelo ◽  
Loren Cadena ◽  
Madalena Soares ◽  
Michael Pratt
Keyword(s):  
Assessment Tool ◽  
Public Health Problem ◽  
Premature Mortality ◽  
Communicable Diseases ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Middle Income Countries ◽  
Care Services ◽  
Primary Care Services ◽  
Challenges And Opportunities

Non-communicable diseases (NCDs) are the leading causes of death worldwide, with higher rates of premature mortality in low- and middle-income countries (LMICs). This places a high economic burden on these countries, which usually have limited capacity to address this public health problem. We developed a guided self-assessment tool for describing national capacity for NCD prevention and control. The purpose of this tool was to assist countries in identifying key opportunities and gaps in NCD capacity. It was piloted in three countries between 2012 and 2013: Mozambique, Colombia, and the Dominican Republic. The tool includes details about NCD burden; health system infrastructure and primary care services; workforce capacity; surveillance; planning, policy, and program management; and partnerships. In the three pilot countries, the tool helped to identify differences in capacity needs pertaining to staff, training, and surveillance, but similarities were also found related to NCD challenges and opportunities. The NCD tool increased our understanding of needs and critical capacity elements for addressing NCDs in the three pilot countries. This tool can be used by other LMICs to map their efforts toward addressing NCD goals and defining priorities.

scholarly journals Multimorbidity of chronic non-communicable diseases and its models of care in low- and middle-income countries: a scoping review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e033320 ◽  
Author(s):  
Fantu Abebe Eyowas ◽  
Marguerite Schneider ◽  
Biksegn Asrat Yirdaw ◽  
Fentie Ambaw Getahun
Keyword(s):  
Scoping Review ◽  
Grey Literature ◽  
Communicable Diseases ◽  
Multiple Chronic Conditions ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Middle Income Countries ◽  
Co Morbidity ◽  
Scoping Reviews ◽  
Low And Middle Income

IntroductionMultimorbidity is the coexistence of two or more chronic non-communicable diseases (NCDs) in a given individual. Multimorbidity is increasing in low- and middle-income countries (LMICs) and challenging health systems. Individuals with multimorbidity are facing the risk of premature mortality, lower quality of life and greater use of healthcare services. However, despite the huge challenge multimorbidity brings in LMICs, gaps remain in mapping and synthesising the available knowledge on the issue. The focus of this scoping review will be to synthesise the extent, range and nature of studies on the epidemiology and models of multimorbidity care in LMICs.MethodsPubMed (MEDLINE) will be the main database to be searched. For articles that are not indexed in the PubMed, Scopus, PsycINFO and Cochrane databases will be searched. Grey literature databases will also be explored. There will be no restrictions on study setting or year of publication. Articles will be searched using key terms, including comorbidity, co-morbidity, multimorbidity, multiple chronic conditions and model of care. Relevant articles will be screened by two independent reviewers and data will be charted accordingly. The result of this scoping review will be presented using the Preferred Reporting Items for Systematic Review and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist and reporting guideline.Ethics and disseminationThis scoping review does not require ethical approval. Findings will be published in peer-reviewed journal and presented at scientific conferences.

scholarly journals The need for an integrated approach for chronic disease research and care in Africa

2016 ◽  
Vol 1 ◽  
Author(s):  
A. L. Barr ◽  
E. H. Young ◽  
L. Smeeth ◽  
R. Newton ◽  
J. Seeley ◽  
...  
Keyword(s):  
Integrated Approach ◽  
Communicable Diseases ◽  
Design Strategies ◽  
Term Care ◽  
Middle Income ◽  
Effective Prevention ◽  
Non Communicable Diseases ◽  
Middle Income Countries ◽  
Epidemiological Transitions

With the changing distribution of infectious diseases, and an increase in the burden of non-communicable diseases, low- and middle-income countries, including those in Africa, will need to expand their health care capacities to effectively respond to these epidemiological transitions. The interrelated risk factors for chronic infectious and non-communicable diseases and the need for long-term disease management, argue for combined strategies to understand their underlying causes and to design strategies for effective prevention and long-term care. Through multidisciplinary research and implementation partnerships, we advocate an integrated approach for research and healthcare for chronic diseases in Africa.

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