scholarly journals Could a simple antenatal package combining micronutritional supplementation with presumptive treatment of infection prevent maternal deaths in sub-Saharan Africa?

2007 ◽  
Vol 7 (1) ◽  
Author(s):  
Simon M Collin ◽  
Rebecca F Baggaley ◽  
Rudiger Pittrof ◽  
Veronique Filippi
Keyword(s):  
Sub Saharan Africa ◽  
Presumptive Treatment ◽  
Maternal Deaths ◽  
Sub Saharan ◽  
Treatment Of Infection

scholarly journals Sustaining Hand Hygiene and Sanitation Campaign in Sub-Saharan Africa: A Glowing Tribute to Ignaz Semmelweis

2018 ◽  
Vol 1 (3) ◽  
pp. x
Author(s):  
G T Jombo ◽  
J O Tsor ◽  
A Orinya
Keyword(s):  
Health Education ◽  
Hand Hygiene ◽  
Puerperal Fever ◽  
Strong Association ◽  
Communicable Diseases ◽  
Sub Saharan Africa ◽  
Maternal Deaths ◽  
Avoidable Deaths ◽  
Sub Saharan

Ignaz Semmelweis the father of hand hygiene made this startling discovery of strong association of contaminated hands with incidence of puerperal fever and deaths in 1847 and embarked on aggressive campaign to stem the tide of maternal deaths at that time and eventually succumbed to death due to septicaemia in 1865. At present about 171 years since this discovery, the entire humanity is yet to fully embrace the full practice of hand hygiene and reduce as much as half of the morbidities and mortalities from communicable diseases across the globe. Sub-Saharan Africa remains the last stronghold of millions of avoidable deaths from poor hand hygiene and 156 million people from Nigeria are yet to have access to facilities for hand hygiene.  Facilities for hand hygiene should be adequately provided in all hospitals and clinics, schools and all settings experiencing assemblage of crowds while health education and advocacy is stepped. This will serve as a mark of honour to Ignaz Semmelweis, the man that paid the supreme price saving the lives of millions across the globe in defence of hand hygiene.

scholarly journals Magnitude, Trends and Causes of Maternal Mortality: A 7-year Review at a Tertiary Hospital in Rivers State, Nigeria

2020 ◽  
pp. 103-109
Author(s):  
P. A. Awoyesuku ◽  
D. A. MacPepple ◽  
B. O. Altraide
Keyword(s):  
Maternal Mortality ◽  
Postpartum Haemorrhage ◽  
Maternal Mortality Ratio ◽  
Tertiary Hospital ◽  
Sub Saharan Africa ◽  
Annual Reports ◽  
Maternal Deaths ◽  
Middle Income ◽  
Mortality Ratio ◽  
Sub Saharan

Background: Maternal mortality ratios (MMR) are still unacceptably high in many low- and middle-income countries especially in sub-Saharan Africa. Background Data for the causes of maternal deaths are needed to inform policies to improve maternal healthcare and reduce maternal mortality. Objective: This study sought to determine the magnitude and trend in maternal mortality and the causes at a tertiary hospital over a seven-year study period. Methodology: This was a retrospective review of maternal mortality and causes from 2012 to 2018. Data on number of maternal deaths, deliveries and causes of death were retrieved from the departmental annual reports and hospital records and entered into Microsoft Excel 2013. Data were presented as line graphs, charts and frequency tables. Results: One hundred and ten (110) maternal deaths occurred out of 17,080 total births during the study period giving an overall MMR of 644. The MMR increased progressively from 580 in 2012 to 785 in 2018 with a sharp rise to the highest and subsequent decline to the lowest, values at the midpoint. The commonest causes of maternal deaths were Pre-eclampsia (PET) and Eclampsia 44(40%), Postpartum Haemorrhage (PPH) 25(22.7%) and Ruptured Uterus 13(11.8%). Conclusion: The maternal mortality ratio is high and the trend is worsening. The leading causes of maternal deaths were PET/Eclampsia and Postpartum haemorrhage accounting for about two-thirds of all deaths. Efforts must be geared towards improvements in the management of these cases, if this trend is to be reversed.

scholarly journals Women empowerment and skilled birth attendance in sub-Saharan Africa: A multi-country analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254281
Author(s):  
Kwamena Sekyi Dickson ◽  
Kenneth Setorwu Adde ◽  
Edward Kwabena Ameyaw
Keyword(s):  
Urban Areas ◽  
Working Women ◽  
Skilled Birth Attendance ◽  
Sub Saharan Africa ◽  
Wife Beating ◽  
Demographic And Health Surveys ◽  
Women Empowerment ◽  
Maternal Deaths ◽  
Birth Attendance ◽  
Sub Saharan

Introduction In 2017, the highest global maternal deaths occurred in sub-Saharan Africa (SSA). The WHO advocates that maternal deaths can be mitigated with the assistance of skilled birth attendants (SBAs) at childbirth. Women empowerment is also acknowledged as an enabling factor to women’s functionality and healthcare utilisation including use of SBAs’ services. Consequently, this study investigated the association between women empowerment and skilled birth attendance in SSA. Materials and methods This study involved the analysis of secondary data from the Demographic and Health Surveys of 29 countries conducted between January 1, 2010, and December 3, 2018. For this study, only women who had given birth in the five years prior to the surveys were included, which is 166,022. At 95% confidence interval, Binary Logistic Regression analyses were conducted and findings were presented as adjusted odds ratios (aORs). Results The overall prevalence of skilled birth attendance was 63.0%, with the lowest prevalence in Tanzania (13.8%) and highest in Rwanda (91.2%). Women who were empowered with high level of knowledge (aOR = 1.60, 95% CI = 1.51, 1.71), high decision-making power (aOR = 1.19, 95% CI = 1.15, 1.23), and low acceptance of wife beating had higher likelihood of skill birth attendance after adjusting for socio-demographic characteristics. Women from rural areas had lesser likelihood (OR = 0.53, 95% CI = 0.51–0.55) of skilled birth attendance compared to women from urban areas. Working women had a lesser likelihood of skilled birth attendance (OR = 0.91, 95% CI = 0.88–0.94) as compared to those not working. Women with secondary (OR = 2.13, 95% CI = 2.03–2.22), or higher education (OR = 4.40, 95% CI = 3.81–5.07), and women in the richest wealth status (OR = 3.50, 95% CI = 3.29–3.73) had higher likelihood of skilled birth attendance. Conclusion These findings accentuate that going forward, successful skilled birth attendant interventions are the ones that can prioritise the empowerment of women.

scholarly journals Maternal and Perinatal Mortality in the 21st Century

2016 ◽  
Vol 10 (2) ◽  
pp. 143-146
Author(s):  
Aris Antsaklis
Keyword(s):  
Perinatal Mortality ◽  
21St Century ◽  
Maternal Mortality Ratio ◽  
Geographic Area ◽  
Developed Countries ◽  
Sub Saharan Africa ◽  
Maternal Deaths ◽  
Neonatal Deaths ◽  
Live Births ◽  
Sub Saharan

ABSTRACT The maternal mortality ratio measures how safe it is to become pregnant and give birth in a geographic area or a population. The total number of maternal deaths observed annually fell from 526,000 in 1980 to 358,000 in 2008, a 34% decline over this period. Similarly, the global MMR declined from 422 in 1980 to 320 in 1990 and was 250 per 100,000 live births in 2008, a decline of 34% over the entire period and an average annual decline of 2.3%. More specifically, in 1990 around 58% of maternal deaths worldwide occurred in Asia and 36% in sub-Saharan Africa. In contrast, in 2008, 57% of global maternal deaths occurred in sub-Saharan Africa and 39% in Asia. In Europe, the main causes of death from any known direct obstetric complication remains bleeding (13%), thromboembolic events (10.1%), complicationassociated birth, hypertensive disease of pregnancy (9.2%), and amniotic fluid embolism (10.6%). Preterm birth is the most common cause of perinatal mortality (PNM) causing almost 30% of neonatal deaths, while birth defects cause about 21% of neonatal deaths. The PNM rate refers to the number of perinatal deaths per 1,000 total births. Perinatal mortality rate may be below 10 for certain developed countries and more than 10 times higher in developing countries. Perinatal health in Europe has improved dramatically in recent decades. In 1975, neonatal mortality ranged from 7 to 27 per 1,000 live births in the countries that now make up the EU. By 2005, it had declined to 8 per 1,000 live births. We need to bring together data from civil registration, medical birth registers, hospital discharge systems in order to have European Surveys which present exciting research possibilities. How to cite this article Antsaklis A. Maternal and Perinatal Mortality in the 21st Century. Donald School J Ultrasound Obstet Gynecol 2016;10(2):143-146.

scholarly journals The Association between Maternal Mortality and Non-Medical factors in African Countries

2014 ◽  
Vol 6 (5) ◽  
pp. 351-362
Author(s):  
P. Lalthapersad-Pillay
Keyword(s):  
Developing Countries ◽  
Logistic Regression ◽  
Maternal Mortality ◽  
National Income ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Maternal Deaths ◽  
Medical Factors ◽  
Pregnancy And Childbirth ◽  
Sub Saharan

The medical expertise to treat to complications arising from pregnancy and childbirth has not spared girls and women in developing countries from dying of such conditions. Developing countries account for the bulk of the global share of maternal deaths with complications of pregnancy and childbirth being the leading cause of death in young women aged between 15 and 49. Sub-Saharan Africa is responsible for nearly three-fifths of all global maternal deaths which have saddled it with notoriously high levels of maternal mortality ratios, a concern that has been red-flagged internationally and regionally. Most studies on maternal mortality in Africa have been confined to an examination of factors impinging on maternal mortality from both medical and socioeconomic standpoints for individual country’s based on survey data. Our study differs from others as it employs logistic regression to look at the association between non-medical factors and maternal mortality nationally for all African countries. Whilst the results from the logistic regression suggests that there is no statistically significant relationship between any of the variables and maternal mortality, the odds ratio for Human Development Index (HDI) and Gross National Income per capita (GNI) imply that African countries with low HDI are about three time more likely to have high maternal mortality compared to high HDI countries. Similarly, African countries with low GNI are about five times more likely to have high maternal mortality compared to high GNI countries.

scholarly journals Protocol for analysing the epidemiology of maternal mortality in Zimbabwe: A civil registration and vital statistics trend study

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252106
Author(s):  
Reuben Musarandega ◽  
Rhoderick Machekano ◽  
Robert Pattinson ◽  
Stephen Peter Munjanja ◽  
Keyword(s):  
Maternal Mortality ◽  
Causes Of Death ◽  
International Classification Of Diseases ◽  
Vital Statistics ◽  
Sub Saharan Africa ◽  
Maternal Deaths ◽  
Civil Registration ◽  
Classification Of Diseases ◽  
Sub Saharan ◽  
Ssa Countries

Background Sub-Saharan Africa (SSA) carries the highest burden of maternal mortality, yet, the accurate maternal mortality ratios (MMR) are uncertain in most SSA countries. Measuring maternal mortality is challenging in this region, where civil registration and vital statistics (CRVS) systems are weak or non-existent. We describe a protocol designed to explore the use of CRVS to monitor maternal mortality in Zimbabwe—an SSA country. Methods In this study, we will collect deliveries and maternal death data from CRVS (government death registration records) and health facilities for 2007–2008 and 2018–2019 to compare MMRs and causes of death. We will code the causes of death using classifications in the maternal mortality version of the 10th revision to the international classification of diseases. We will compare the proportions of maternal deaths attributed to different causes between the two study periods. We will also analyse missingness and misclassification of maternal deaths in CRVS to assess the validity of their use to measure maternal mortality in Zimbabwe. Discussion This study will determine changes in MMR and causes of maternal mortality in Zimbabwe over a decade. It will show whether HIV, which was at its peak in 2007–2008, remains a significant cause of maternal deaths in Zimbabwe. The study will recommend measures to improve the quality of CRVS data for future use to monitor maternal mortality in Zimbabwe and other SSA countries of similar characteristics.

scholarly journals Juridification of maternal deaths in Ethiopia: a study of the Maternal and Perinatal Death Surveillance and Response (MPDSR) system

2020 ◽  
Vol 35 (8) ◽  
pp. 900-905
Author(s):  
Andrea Melberg ◽  
Lidiya Teklemariam ◽  
Karen Marie Moland ◽  
Henriette Sinding Aasen ◽  
Mitike Molla Sisay
Keyword(s):  
Health System ◽  
Health Workers ◽  
Perinatal Death ◽  
Legal Protection ◽  
Sub Saharan Africa ◽  
Legal Responsibility ◽  
Maternal Deaths ◽  
Reporting Practices ◽  
Surveillance And Response ◽  
Sub Saharan

Abstract Juridification of maternal health care is on the rise globally, but little is known about its manifestations in resource constrained settings in sub-Saharan Africa. The Maternal and Perinatal Death Surveillance and Response (MPDSR) system is implemented in Ethiopia to record and review all maternal and perinatal deaths, but underreporting of deaths remains a major implementation challenge. Fear of blame and malpractice litigation among health workers are important factors in underreporting, suggestive of an increased juridification of birth care. By taking MPDSR implementation as an entry point, this article aims to explore the manifestations of juridification of birth care in Ethiopia. Based on multi-sited fieldwork involving interviews, document analysis and observations at different levels of the Ethiopian health system, we explore responses to maternal deaths at various levels of the health system. We found an increasing public notion of maternal deaths being caused by malpractice, and a tendency to perceive the juridical system as the only channel to claim accountability for maternal deaths. Conflicts over legal responsibility for deaths influenced birth care provision. Both health workers and health bureaucrats strived to balance conflicting concerns related to the MPDSR system: reporting all deaths vs revealing failures in service provision. This dilemma encouraged the development of strategies to avoid personalized accountability for deaths. In this context, increased juridification impacted both care and reporting practices. Our study demonstrates the need to create a system that secures legal protection of health professionals reporting maternal deaths as prescribed and provides the public with mechanisms to claim accountability and high-quality birth care services.

scholarly journals Determinants of completing recommended antenatal care utilization in sub-Saharan from 2006 to 2018: evidence from 36 countries using Demographic and Health Surveys

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zemenu Tadesse Tessema ◽  
Achamyeleh Birhanu Teshale ◽  
Getayeneh Antehunegn Tesema ◽  
Koku Sisay Tamirat
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Logistic Regression Model ◽  
Sub Saharan Africa ◽  
Care Utilization ◽  
Multivariable Logistic Regression Model ◽  
Maternal Deaths ◽  
Pooled Prevalence ◽  
Antenatal Care Utilization ◽  
Sub Saharan

Abstract Background Every day in 2017, approximately 810 women died from preventable causes related to pregnancy and childbirth, with 99% of these maternal deaths occurring in low and lower-middle-income countries. Sub-Saharan Africa (SSA) alone accounts for roughly 66%. If pregnant women gained recommended ANC (Antenatal Care), these maternal deaths could be prevented. Still, many women lack recommended ANC in sub-Saharan Africa. This study aimed at determining the pooled prevalence and determinants of recommended ANC utilization in SSA. Methods We used the most recent standard demographic and health survey data from the period of 2006 to 2018 for 36 SSA countries. A total of 260,572 women who had at least one live birth 5 years preceding the survey were included in this study. A meta-analysis of DHS data of the Sub-Saharan countries was conducted to generate pooled prevalence, and a forest plot was used to present it. A multilevel multivariable logistic regression model was fitted to identify determinants of recommended ANC utilization. The AOR (Adjusted Odds Ratio) with their 95% CI and p-value ≤0.05 was used to declare the recommended ANC utilization determinates. Results The pooled prevalence of recommended antenatal care utilization in sub-Saharan Africa countries were 58.53% [95% CI: 58.35, 58.71], with the highest recommended ANC utilization in the Southern Region of Africa (78.86%) and the low recommended ANC utilization in Eastern Regions of Africa (53.39%). In the multilevel multivariable logistic regression model region, residence, literacy level, maternal education, husband education, maternal occupation, women health care decision autonomy, wealth index, media exposure, accessing health care, wanted pregnancy, contraceptive use, and birth order were determinants of recommended ANC utilization in Sub-Saharan Africa. Conclusion The coverage of recommended ANC service utilization was with high disparities among the region. Being a rural residence, illiterate, low education level, had no occupation, low women autonomy, low socioeconomic status, not exposed to media, a big problem to access health care, unplanned pregnancy, not use of contraceptive were determinants of women that had no recommended ANC utilization in SSA. This study evidenced the existence of a wide gap between SSA regions and countries. Special attention is required to improve health accessibility, utilization, and quality of maternal health services.

Sign in / Sign up

Export Citation Format

Share Document