scholarly journals Maternal and newborn healthcare practices: assessment of the uptake of lifesaving services in Hoima District, Uganda

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Geoffrey Babughirana ◽  
Sanne Gerards ◽  
Alex Mokori ◽  
Elisha Nangosha ◽  
Stef Kremers ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Maternal Mortality Ratio ◽  
Newborn Care ◽  
Poor Quality ◽  
Birth Preparedness ◽  
Essential Newborn Care ◽  
Complication Readiness ◽  
Live Births ◽  
Danger Signs ◽  
Maternal And Newborn

Abstract Background The current maternal mortality ratio in Uganda is 336 maternal deaths per 100,000 live births. Infant mortality is 43 deaths per 1000 live births, with 42% of the mortality occurring during the neonatal period. This might be related to a weak health system in the country. This study aimed at assessing the uptake of lifesaving services during pregnancy and childbirth in Hoima District, Uganda. Methods The study used a cross-sectional quantitative design among 691 women with a child under 5 years. Households were randomly sampled from a list of all the villages in the district with the ENA for SMART software using the EPI methodology. Pre-coded questionnaires uploaded in the Open Data Kit were used for data collection. The data was cleaned and analysed using MS Excel and SPSS software. Descriptive results are presented. Results Of the 55.1% women attending at least four antenatal care (ANC) visits, only 24.3% had the first ANC within the first trimester. Moreover, ANC services generally was of poor quality, with only 0.4% meeting all the requirements for quality of ANC service. The highest contributors to this poor quality included poor uptake of iron-folic acid (adherence 28.8%), the six-required birth preparedness and complication readiness items (13.2%), and recognition of the seven danger signs of pregnancy (3.0%). Adherence to the seven essential newborn care actions was very low (0.5%), mainly caused by three practices: initiating breastfeeding within 1 h (59.9%), lack of postnatal care within 24 h (20.1%), and failure to recognize the 6 danger signs of the newborn (2.4%). Only 11.1% of the males participated in all maternal and newborn care requirements, by encouraging women to seek healthcare (39.9%), accompanying them to healthcare (36.9%), and HIV counselling and support services (26.2%). Conclusion The study reveals poor maternal and newborn practices throughout the continuum of care, from ANC and skilled birth attendance to newborn care during childbirth. With such poor results, it is not surprising that Hoima is sixth of 10 districts that have the highest numbers of deaths due to maternal mortality in Uganda.

scholarly journals Factors Associated with Men’s Awareness of Danger Signs of Obstetric Complications and Its Effect on Men’s Involvement in Birth Preparedness Practice in Southern Ethiopia, 2014

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Alemu Tamiso Debiso ◽  
Behailu Merdekios Gello ◽  
Marelign Tilahun Malaju
Keyword(s):  
Maternal Mortality ◽  
Maternal Mortality Ratio ◽  
Obstetric Complications ◽  
Southern Ethiopia ◽  
Birth Preparedness ◽  
Danger Sign ◽  
Live Births ◽  
Danger Signs ◽  
Mortality Ratio ◽  
Men’S Involvement

Background. Compared to average maternal mortality ratio of 8 per 100,000 live births in industrialized countries, Ethiopia has an estimated maternal mortality ratio of 676 per 100,000 live births. Maternal deaths can be prevented partially through increasing awareness of danger signs of obstetric complications and involving husbands (male) in birth preparedness practice.Methods. Community based cross-sectional study was done. All adult males with a wife or partner who lives in the selected kebeles were our study population. Data was collected by pretested and structured questionnaires and two-stage cluster sampling procedure was used in order to collect study samples. Data was cleaned and entered into Epi Info 7 and exported to SPSS (IBM-21) for further analysis. Ordinary and hierarchical logistic regression model were used and AOR with 95% CI were used to show factors and the effect of men’s awareness of danger sign on men’s involvement in birth preparedness practice.Results. Total numbers of men interviewed were 836 making a response rate of 98.9%. 42% of men had awareness of danger sign and 9.4% (95% CI: (7.42, 11.4) of men were involved in birth preparedness practice. Respondents who live in the rural area [(AOR: 8.41; (95% CI: (4.99, 14.2)], governments employee [(AOR: 3.75; (95% CI: (1.38, 10.2)], those who belong to the highest wealth quintile [(AOR: 3.09; (95% CI: (1.51, 6.34)], and husbands whose wives gave birth in the hospital [(AOR: 2.09; (95% CI: (1.29, 3.37)], health center [(AOR: 1.99; (95% CI: (1.21, 3.28)], and health post [(AOR: 2.2; (95% CI: 2.16 (1.06, 404)] were positively associated and those who had no role in the health development army [(AOR: 0.43; (95% CI: (0.26, 0.72)] were negatively associated with men’s awareness of danger signs of obstetric complications.Conclusion. The prevalence of men awareness of danger sign was low and male involvement in birth preparedness practice was very low. Since there is a low level of awareness (17.1%) particularly in the urban area and men act as gatekeepers to women’s health, the respective organization needs to review urban health extension program and give due emphasis to husband education in order that they are able to recognize danger signs of obstetric complications in a way to increase their involvement in birth preparedness practice.

scholarly journals Trends of maternal mortality at a tertiary health care centre in India

2020 ◽  
Vol 9 (9) ◽  
pp. 3754
Author(s):  
Deepali S. Kapote ◽  
Anam B. Syed ◽  
Swati C. Gawai ◽  
Ashwini S. Desai ◽  
Apeksha M. Mohite
Keyword(s):  
Health Care ◽  
Maternal Mortality ◽  
Maternal Mortality Ratio ◽  
Health Care Facilities ◽  
Hypertensive Disorder ◽  
Health Care Centre ◽  
Maternal Deaths ◽  
Live Births ◽  
Danger Signs ◽  
Mortality Ratio

Background: Maternal mortality is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of duration and site of pregnancy from any cause, related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.Methods: A retrospective study was conducted by reviewing the hospital records to study the maternal deaths and complication leading to maternal death over the period of one year from January 2019 to December 2019 in the department of obstetrics and gynecology, LTMMC and Sion Hospital.Results: The maternal mortality ratio in the present study 548/100000 live births and corrected MMR’s 190/live births. There were 49 deaths of 8093 live birth during the study period. The majority of deaths occurred in the 20-30 age group. Hemorrhage (22.4%) and hypertensive disorder (14.2%) are two most common direct cause of maternal deaths. 46.9% of maternal deaths occurred after 72 hours of death. Indirect cause accounts for 73.5%. Of these deaths and DIC with sepsis was the leading indirect cause of maternal deaths.Conclusions: Hemorrhage, hypertensive disorder, anemia and DIC with sepsis remain major cause of maternal deaths. Delay at primary level, by the patient and family contributed to higher maternal mortality. This requires more effort to educate, impart knowledge to recognize danger signs and seek urgent medical help and create awareness about the easy accessibility and availability of nearby health care facilities amongst the society.

scholarly journals Incidence and Predictors of Maternal and Perinatal Mortality among Women with Severe Maternal Outcomes: A Tanzanian Facility-Based Survey for Improving Maternal and Newborn Care

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Athanase Lilungulu ◽  
Deogratius Bintabara ◽  
Simon Mujungu ◽  
Enid Chiwanga ◽  
Paulo Chetto ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Perinatal Mortality ◽  
Newborn Care ◽  
Referral Hospital ◽  
Maternal Outcomes ◽  
Regional Referral Hospital ◽  
Neonatal Complications ◽  
Live Births ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Introduction. Maternal and perinatal mortality is still a major public health challenge in Tanzania, despite the ongoing government efforts to improve maternal and newborn care. Among the contributors to these problems is the high magnitude of severe maternal outcomes (maternal near-miss). The current study, therefore, aimed to identify the magnitude and predictors of maternal and perinatal mortality among women with severe maternal outcomes admitted to Dodoma Regional Referral Hospital. Methods. A retrospective cross-sectional study was conducted from October 2015 to January 2016 at Dodoma Regional Referral Hospital in Dodoma City. All maternal deaths and maternal near-misses based on WHO criteria were included in this study. Three outcome variables have been identified: maternal mortality, perinatal mortality, and neonatal complications. To examine the predictors for the three predetermined outcome variables, the three logit models each containing unadjusted and adjusted findings were fitted. A P-value less than 0.05 was considered indicative of statistically significant. Results. A total of 3600 pregnant women were admitted for obstetric reasons during the mentioned period. 140 of them were diagnosed with severe maternal outcomes; hence, they were included in this study. The severe maternal outcome incidence ratio was 40.23 per 1000 live births, the institutional maternal mortality ratio was 459.77 per 100000 live births, and the perinatal mortality rate was 10.83 per 1000 total births. Most of the maternal morbidity and mortality were due to direct causes in which postpartum hemorrhage and hypertensive disorders were the leading causes. In adjusted analysis, per-protocol management, maternal age, and mode of birth were predictors of maternal mortality, perinatal mortality, and neonatal complications, respectively. Conclusion. Establishing and strengthening obstetric ICUs will help reduce maternal mortality as the response time from the onset of obstetric complications, while the provision of high-quality care will be substantially reduced. Furthermore, the study recommends regular provision of in-service refresher training to emphasize the practice and compliance of per-protocol case management through a team approach in order to reduce the burden of maternal and perinatal mortality in Tanzania.

scholarly journals Reducing maternal mortality in China in the era of the two-child policy

2020 ◽  
Vol 5 (2) ◽  
pp. e002157
Author(s):  
Jue Liu ◽  
Li Song ◽  
Jie Qiu ◽  
Wenzhan Jing ◽  
Liang Wang ◽  
...  
Keyword(s):  
High Risk ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Maternal Mortality Ratio ◽  
Pregnancy Risk ◽  
Risk Screening ◽  
Live Births ◽  
Child Policy ◽  
Mortality Ratio ◽  
Maternal And Newborn

Reducing maternal mortality ratio (MMR) is of great concern worldwide. After the implementation of the two-child policy in 2013, the number of live births and the proportion of high-risk pregnancies both increased, and these bring new challenges to the reduction of MMR. China implemented a package of nationwide strategies in April 2016, the Five Strategies for Maternal and Newborn Safety (FSMNS). The FSMNS consists of five components: (1) pregnancy risk screening and assessment strategy, (2) case-by-case management strategy for high-risk pregnancies, (3) referral and treatment strategy for critically ill pregnant women and newborns, (4) reporting strategy for maternal deaths (and 5) accountability strategy. To better implement the FSMNS, China formulated a unified pregnancy risk screening form. After risk assessment and classification, medical records of all the pregnant women are labelled with green (low risk), yellow (moderate risk), orange (high risk), red (highest risk) or purple (infectious disease) for tailored management. By the implementation of FSMNS, China has already kept the MMR stable and cause it to enter a controlled decline. MMR in China has declined by 21.1%, from 23.2 per 100 000 live births in 2013 to 18.3 per 100 000 live births in 2018. The country’s challenges and experience in reducing the MMR could provide useful lessons for other countries.

scholarly journals Proposed Framework for Making Focused Antenatal Care Services Accessible: A Review of the Nigerian Setting

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
John Ekabua ◽  
Kufre Ekabua ◽  
Charles Njoku
Keyword(s):  
Antenatal Care ◽  
Maternal Mortality ◽  
Traditional Approach ◽  
Maternal Mortality Ratio ◽  
Teaching Hospitals ◽  
Care Group ◽  
Birth Preparedness ◽  
Skilled Attendant ◽  
Complication Readiness ◽  
Focused Antenatal Care

The aim of this paper is to propose a framework for making antenatal care an effective strategy in reducing the high maternal mortality ratio in Nigeria. On-site visits to five teaching hospitals were carried out between 2006 and 2008 to assess the practice of antenatal care. Group discussions with 200 parturients on their awareness of birth preparedness/complication readiness were conducted, in October, 2008. The findings of this study are discussed in line with the proposed practice of focused antenatal care. The practice of antenatal care in all the hospitals visited was the traditional approach based on earlier European models. Awareness of birth preparedness/complication readiness, by parturients, as a goal-directed intervention during antenatal care was low (21.5%). To reduce maternal deaths through antenatal care, it is critical to link care with detecting and treating causes of maternal mortality by a skilled attendant.

scholarly journals Does knowledge of danger signs influence use of maternal health services among rural women? Findings from Babati Rural district, Northern Tanzania.

2019 ◽  
Author(s):  
Edwin Joseph Shewiyo ◽  
Minael G Mjemmas ◽  
Faidha H Mwalongo ◽  
Ester J. Diarz ◽  
Sia E. Msuya ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Care Providers ◽  
Rural Women ◽  
Rural District ◽  
Birth Preparedness ◽  
Care Providers ◽  
Complication Readiness ◽  
Obstetric Danger Signs ◽  
Danger Signs ◽  
Maternal And Newborn

Abstract Background Increasing knowledge on obstetric danger signs (DS) among pregnant women and their families is one of the interventions targeted to reduce maternal and newborn mortality. It is expected that knowledge in DS will lead to early care seeking once complications occur among women or newborns. Health care providers are required to educate women on DS of obstetric emergency during pregnancy, delivery and immediate-post-delivery. This study aimed to determine the level of knowledge on danger signs among rural women and its effect on antenatal care visits, birth preparedness and complication readiness (BPCR) and on use of skilled birth attendance (SBA) during childbirth.Methodology Community-based analytical cross-sectional study was conducted in July 2019 among women who delivered in the past 24 months in two wards at Babati Rural district, Tanzania. Questionnaire was used for data collection. Odds Ratio was used to assess association between knowledge on danger signs with use of services during pregnancy and childbirth.Results A total of 372 women were enrolled, with mean age of 28.5 years (S.D 7.2). All the women attended antenatal care at least once during pregnancy, 65.3% attended ANC 4 or more visits, 85.2% of women were assisted by SBA during childbirth, and 13.7% of the women had birth preparedness and complication readiness plan. Overall, 272 (73.1%) women reported that they were counseled about obstetric danger signs during antenatal clinic visits, but only 32% could mention three or more DS of obstetric and newborn emergency. Overall good knowledge of DS and knowledge of obstetric danger signs during pregnancy were significantly associated with 4 or more ANC visits and birth preparedness and complication readiness but not with SBA use during childbirth.Conclusion Majority of women were counseled on DS during pregnancy, however more than three quarters (68%) had low knowledge. Women who were knowledgeable on danger signs during pregnancy attended 4+ ANC visits and prepared for birth and its complications. There is a need of designing alternative models of engaging women during education/ counseling sessions so that they may have a higher retention of knowledge not only of danger signs but for other maternal and newborn health issues.

scholarly journals Community Based Essential Newborn Care Practices and Associated Factors among Women Who Gave Birth at Home in Last Twelve Months in Amaro Woreda, Southern Ethiopia, 2019

2019 ◽  
Author(s):  
Mamush Agonafir ◽  
Mulugeta Shegaze Shimbre ◽  
Sultan Hussen ◽  
Gebremaryam Temesgen ◽  
Goytom Girmay ◽  
...  
Keyword(s):  
Newborn Care ◽  
Educational Status ◽  
Southern Ethiopia ◽  
Care Practice ◽  
Birth Preparedness ◽  
Community Based ◽  
Essential Newborn Care ◽  
Complication Readiness ◽  
Care Practices ◽  
At Home

Abstract Introduction:- Significant numbers of women are giving birth at home; in this case community based newborn care is a means of bringing life-saving care to mothers and newborns at the community level. However, practice is challenging within the Ethiopian health system. Objective:- The aim of this study was to assess prevalence of community based newborn care practices and its associated factors among women who gave birth at home in Amaro Woreda, southern Ethiopia, 2019. Methods:- Across-sectional study was conducted on 490 women in the reproductive age groups of 15-49 in Amaro district and by using simple random sampling technique individual was recruited. Data collected through face-to-face interview at household level. EpiData version 3.1 statistical software was used for entry and SPSS version 20 for was used for data cleaning, management and analysis. Bi-variate and multivariate logistic regression analysis employed for analysis of factors associated with Community based newborn care practices. Results:- A total 490 of study participants were included in the analysis and only 29% practiced community based essential newborn care. Educational status of father [AOR=2.28; 95%CI:1.07-4.84] & mother [AOR=0.35; 95%CI: 0.16-0.75], last delivery assisted by relative/friends [AOR=3.58; 95%CI: 1.66-7.73], having awareness about Community based newborn care [AOR=3.49; 95%CI: 2.11-5.77], awareness about newborn danger sign [AOR=2.18; 95%CI: 1.29-3.68] and having birth preparedness and complication readiness plan [AOR=3.52; 95%CI: 1.97-6.29] were an identified independent factors associated with Community based newborn care Practice. Conclusion and recommendation:- Around three-fourth (71%) of mothers were not practicing Community based newborn care. Educational status of family, awareness about community based newborn care and newborn danger sign, last delivery assisted by relative or friends at home, and having birth preparedness and complication readiness plan were identified as independent factors for community based newborn care practice. Promotion of information at community level, women empowerment and health extension program strengthening are recommending.

Impact of National Health Mission of India on Infant and Maternal Mortality: A Logical Framework Analysis

2021 ◽  
pp. 097206342199498
Author(s):  
Rajesh Kumar
Keyword(s):  
Maternal Mortality ◽  
Health System ◽  
National Health ◽  
Maternal Mortality Ratio ◽  
Evaluation Framework ◽  
Infant Mortality Rate ◽  
Series Data ◽  
Health Management Information System ◽  
Live Births ◽  
Fund Allocation

Background: Since independence, life expectancy has increased substantially in India, but the goal of health-for-all has not been achieved yet. Hence, National Rural Health Mission was launched in 2005, and several strategies were implemented to strengthen the health system. Impact evaluation of the mission was done to learn lessons for future health planning. Materials and Methods: Logical evaluation framework was used to examine input, output and impact indicators systematically using time series data from Health Management Information System, National Family Health Surveys, National Sample Surveys and Sample Registration Scheme. Findings: After launch of the mission, fund allocation has increased nearly five times. The number of auxiliary nurse midwives has doubled, and the number of nurses has trebled. The number of accredited social health activists has increased to about one million. Institutional deliveries have increased from 38.7% in 2005–2006 to 78.9% in 2015–2016. Full immunisation coverage has increased from 43.5% to 62%. Oral rehydration solution (ORS) use in childhood diarrhoea has increased from 26% to 51%. Infant mortality rate has declined from 58 in 2005 to 33 per 1,000 live births in 2017 and maternal mortality ratio has also registered a decline from 254 in 2004–2006 to 122/100000 live births in 2015–2017. However, out-of-pocket health expenditure continues to be fairly high (69.3% of the total expenditure on health). Conclusions: Though National Health Mission has made a significant impact, the goal of universal care coverage is not yet fully achieved. Hence, capacity of health system needs to be trebled by a substantial increase in fund allocation.

Shared Decision-making in Maternal and Newborn Health in Burkina Faso

2015 ◽  
Vol 5 (2) ◽  
pp. 68-73
Author(s):  
Janet Perkins ◽  
Cecilia Capello ◽  
Aminata Bargo ◽  
Carlo Santarelli
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Burkina Faso ◽  
Health Sector ◽  
Newborn Health ◽  
Maternal And Newborn Health ◽  
Birth Preparedness ◽  
Care Providers ◽  
Complication Readiness ◽  
Maternal And Newborn

Community participation in decision-making within the health sector is an essential component in advancing efforts toward primary health care (PHC). Since 2006, Enfants du Monde, a Swiss non-governmental organization (NGO), in collaboration with the local NGO Fondation pour le Développement Communautaire/Burkina Faso (FDC/BF), has been supporting the Ministry of Health (MoH) to include communities in decision-making related to maternal and newborn health (MNH) services. Notably, participatory community assessments (PCA) are conducted to provide a platform for community members to discuss MNH needs and be involved in the decision-making within the health sector. During the PCAs, participants identify and prioritize needs and propose solutions to improve MNH, solutions which are then integrated in the annual district health action plan. Integrated interventions include: promotion of birth preparedness and complication readiness; training health care providers in counselling skills; building awareness of men on MNH issues and their capacity to support women; and strengthening community bodies to manage obstetrical and neonatal complications. The inclusion of these interventions has contributed to the advancement of PHC in three regions in Burkina Faso.     

scholarly journals Two year review of maternal mortality at a tertiary care hospital of GMERS, Valsad, Gujarat, India

2018 ◽  
Vol 7 (6) ◽  
pp. 2283
Author(s):  
Darshna M. Patel ◽  
Mahesh M. Patel ◽  
Vandita K. Salat
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Rural Areas ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Maternal Mortality Rate ◽  
Live Births ◽  
Mortality Ratio

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.

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