scholarly journals A qualitative study of community elders’ perceptions about the underutilization of formal maternal care and maternal death in rural Nigeria

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Arone Wondwossen Fantaye ◽  
Friday Okonofua ◽  
Lorretta Ntoimo ◽  
Sanni Yaya
Keyword(s):  
Rural Communities ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Maternal Care ◽  
Mortality Rates ◽  
Formal Care ◽  
Community Awareness ◽  
Care Services ◽  
Rural Nigeria ◽  
Perceived Reasons

Abstract Background Underutilization of formal maternal care services and accredited health attendants is a major contributor to the high maternal mortality rates in rural communities in Nigeria. Perceptions of a poor quality of care and inaccessible services in health facilities strongly influence the low use of formal maternal care services. There is therefore a need to understand local perceptions about maternal health services utilization and maternal death. This study thereby aims to explore perceptions and beliefs about the underutilization of formal care and causes of maternal death, as well as to identify potential solutions to improve use and reduce maternal mortality in rural Nigeria. Methods Data were collected through 9 community conversations, which were conducted with 158 community elders in 9 rural communities in Edo State, Nigeria. Data from transcripts were analyzed through inductive thematic analysis using NVivo 12 software. Results Perceived reasons for the underutilization of formal maternal care included poor qualities of care, physical inaccessibility, financial inaccessibility, and lack of community knowledge. Perceived reasons for maternal death were related to medical causes, maternal healthcare services deficiencies, uptake of native maternal care, and poor community awareness and negligence. Elders identified increased access to adequate maternal care, health promotion and education, community support, and supernatural assistance from a deity as solutions for increasing use of formal maternal care and reducing maternal mortality rates. Conclusion Study results revealed that multifaceted approaches that consider community contexts, challenges, and needs are required to develop acceptable, effective and long-lasting positive changes. Interventions aiming to increase use of formal care services and curb maternal mortality rates must target improvements to the technical and interpersonal qualities of care, ease of access, community awareness and knowledge, and allow community members to actively engage in implementation phases.

Determinants of Maternal Mortality in Rural China

1996 ◽  
Vol 9 (1) ◽  
pp. 45-54 ◽  
Author(s):  
Q. Li ◽  
M. D. Fottler
Keyword(s):  
Maternal Mortality ◽  
Rural Areas ◽  
Maternal Care ◽  
Economic Status ◽  
Care Facility ◽  
Health Care Facility ◽  
Mortality Rates ◽  
Future Research ◽  
Socio Economic Status ◽  
On The Road

A case-control study of maternal mortality was conducted in selected rural areas of two provinces in China: Henan province, which has a relatively lower socio-economic status and higher maternal mortality rates, and Jiangsu province with higher socio-economic status and lower maternal mortality rates. The major cause of maternal mortality in the two provinces was postpartum hemorrhage and the largest proportion of deaths occurred on the road between the women's home and the health care facility. Results indicate that the expectant mother's socio-economic status, knowledge of maternal care, and the nature and level of maternal care provided all influence rural maternal death rates. However, socio-economic factors were only significant predictors of mortality in the poorer province. Implications for health policy and future research are discussed.

scholarly journals Determinants of neonatal, postneonatal and maternal mortality on models of primary health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A B Guerra ◽  
L M Guerra ◽  
L F Probst ◽  
B V Castro Gondinho ◽  
G M Bovi Ambrosano ◽  
...  
Keyword(s):  
Health Care ◽  
Infant Mortality ◽  
Maternal Mortality ◽  
Public Policies ◽  
Family Health ◽  
Mortality Rates ◽  
Sao Paulo ◽  
The State ◽  
Care Organization ◽  
São Paulo

Abstract Background The state of São Paulo recorded a significant reduction in infant mortality, but the desired reduction in maternal mortality was not achieved. Knowledge of the factors with impact on these indicators would be of help in formulating public policies. The aims of this study were to evaluate the relations between socioeconomic and demographic factors, health care model and both infant mortality and maternal mortality in the state of São Paulo, Brazil. Methods In this ecological study, data from national official open sources were used. Analyzed were 645 municipalities in the state of São Paulo, Brazil. For each municipality, the infant mortality and maternal mortality rates were calculated for every 1000 live births, 2013. The association between these rates, socioeconomic variables, demographic models and the primary care organization model in the municipality were verified. We used the zero-inflated negative binomial model. Gross analysis was performed and then multiple regression models were estimated. For associations, we adopted “p” at 5%. Results The increase in the HDI of the city and proportion of Family Health Care Strategy implemented were significantly associated with the reduction in both infant mortality (neonatal + post-neonatal) and maternal mortality rates. In turn, the increase in birth and caesarean delivery rates were associated with the increase in infant and maternal mortality rates. Conclusions It was concluded that the Family Health Care Strategy model that contributed to the reduction in infant (neonatal + post-neonatal) and maternal mortality rates, and so did actors such as HDI and cesarean section. Thus, public health managers should prefer this model. Key messages Implementation of public policies with specific focus on attenuating these factors and making it possible to optimize resources, and not interrupting the FHS. Knowledge of the factors with impact on these indicators would be of help in formulating public policies.

scholarly journals A Pilot Study of the Effects of Formal Service on Japanese Family Caregivers’ Daily Fluctuation of Stress

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 355-356
Author(s):  
Koji Abe
Keyword(s):  
Family Caregivers ◽  
Fixed Effects ◽  
Psychological Symptoms ◽  
Daily Diary ◽  
Formal Care ◽  
Older Individuals ◽  
Daily Fluctuation ◽  
Japanese Family ◽  
Care Services ◽  
Formal Services

Abstract Purpose: Recent studies report daily fluctuations in stress among family caregivers of older individuals with dementia. Several studies focused on daily stressors or behavioral and psychological symptoms of dementia and use of adult day services. Most previous studies on daily fluctuations of caregivers’ stress have used a daily diary approach. This approach involves creating multiple daily reports, making it possible to examine between-person differences and within-person processes of change. However, only few studies used this approach for family caregivers in Asian countries. Therefore, this study examines the applicability of a daily diary approach for Japanese family caregivers and the effects of formal care services on their stress and depression. Methods: Participants were 13 family caregivers of individuals with dementia using formal care services in a rural area in Japan. They were assessed through self-administered questionnaires including use or nonuse of formal care services, caregiving stressors (DASC-8), depressive symptoms (K-6), and caregiving stress for 7 days. Generalized linear mixed models (GLMM) with data nested within persons were used to examine the effects of formal services on stress and depression. Results: For the GLMM procedure, this study used caregiving stressors and stress variables as fixed effects and participants as random effects. Results indicated that use of formal services significantly lowered caregivers’ stress and depression. Conclusion: The findings demonstrate the applicability of a daily diary approach and the effectiveness of formal services on the stress of Japanese family caregivers.

scholarly journals Prevalence and Correlates of Alcohol Use among a Sample of Nigerian Semirural Community Dwellers in Nigeria

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Victor Olufolahan Lasebikan ◽  
Bolanle Adeyemi Ola
Keyword(s):  
Rural Communities ◽  
Alcohol Use ◽  
Health Risk ◽  
Risk Scores ◽  
Low Socioeconomic ◽  
Care Services ◽  
Associated Risk Factors ◽  
Substance Involvement ◽  
Current Alcohol ◽  
Community Dwellers

Objective. To determine the prevalence and correlates of alcohol use among a sample of Nigerian semirural community dwellers in Nigeria.Methods. In a single arm nonrandomized intervention study, the assessment of baseline hazardous and harmful alcohol use and associated risk factors was conducted in two semirural local government areas of Oyo State, Nigeria, with the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Participants included 1203 subjects 15 years and older, recruited between October 2010 and April 2011. ASSIST score of 0–10 was classified as lower risk scores, 11–26 as moderate risk, and 27+ as high risk.Results. Prevalence of lifetime alcohol use was 57.9% and current alcohol use was 23.7%. Current alcohol use was more prevalent among the younger age groupp=0.02, male genderp=0.003, unmarriedp<0.01, low educational levelp=0.003, low socioeconomic classp=0.01, unemployedp<0.001, and the Christiansp<0.01. Of the current drinkers, the majority (69.1%) were at either moderate or high health risk from alcohol use.Conclusion. Alcohol consumption is prevalent in semirural communities in Nigeria and the majority of these drinkers are at moderate or high health risk. Screening, brief intervention, and referral for treatment for unhealthy alcohol use should be integrated into community care services in Nigerian rural communities.

scholarly journals Temporal evolution and spatial distribution of maternal death

2014 ◽  
Vol 48 (4) ◽  
pp. 662-670 ◽  
Author(s):  
Ioná Carreno ◽  
Ana Lúcia de Lourenzi Bonilha ◽  
Juvenal Soares Dias da Costa
Keyword(s):  
Spatial Distribution ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Temporal Evolution ◽  
Maternal Mortality Ratio ◽  
Rio Grande ◽  
The State ◽  
Rio Grande Do Sul ◽  
Maternal Risk ◽  
Mortality Ratio

OBJECTIVE To analyze the temporal evolution of maternal mortality and its spatial distribution.METHODS Ecological study with a sample made up of 845 maternal deaths in women between 10 and 49 years, registered from 1999 to 2008 in the state of Rio Grande do Sul, Southern Brazil. Data were obtained from Information System on Mortality of Ministry of Health. The maternal mortality ratio and the specific maternal mortality ratio were calculated from records, and analyzed by the Poisson regression model. In the spatial distribution, three maps of the state were built with the rates in the geographical macro-regions, in 1999, 2003, and 2008.RESULTS There was an increase of 2.0% in the period of ten years (95%CI 1.00;1.04; p = 0.01), with no significant change in the magnitude of the maternal mortality ratio. The Serra macro-region presented the highest maternal mortality ratio (1.15, 95%CI 1.08;1.21; p < 0.001). Most deaths in Rio Grande do Sul were of white women over 40 years, with a lower level of education. The time of delivery/abortion and postpartum are times of increased maternal risk, with a greater negative impact of direct causes such as hypertension and bleeding.CONCLUSIONS The lack of improvement in maternal mortality ratio indicates that public policies had no impact on women’s reproductive and maternal health. It is needed to qualify the attention to women’s health, especially in the prenatal period, seeking to identify and prevent risk factors, as a strategy of reducing maternal death.

scholarly journals Community Awareness and Involvement Towards Ecotourism Activities in Ranau, Sabah

2019 ◽  
pp. 3-8
Keyword(s):  
Rural Communities ◽  
Pearson Correlation ◽  
Local Communities ◽  
State Governments ◽  
Positive Perception ◽  
Level Of Involvement ◽  
Face To Face ◽  
Community Awareness ◽  
Revenue Sources ◽  
The Impact

The question of whether the impact of having rural communities nearby an ecotourism area being positive or negative is one of the important issues in Ranau. Cooperation between villagers and park operator on the growth of tourists’ arrival is crucial and must be addressed. The aim of this study is to identify the local communities’ perception at Kampung Poring and Kampung Monggis, Ranau by mean if the ecotourism activities can uplift their economic, social, physical and general impression that they experienced. In addition, the involvements of local communities in ecotourism activities in their villages were also studied. A survey and face to face interview were carried out on a sample of 146 villagers from both study areas. Data analysis using frequency, mean scores and Pearson Correlation (2-sided) was conducted. From the result, positive perception has been perceived by the villagers as a result of the improvement of ecotourism activities such as increase in employment opportunities, infrastructure facilities have been upgraded, additional revenue sources for state governments and villagers as well as increase in Small and Medium Industries (SMIs). However, the perception and level of involvement of both villages is still at the moderate level, where many other issues still need to be improved in the future such as communication skills and accommodations. In conclusion, this matter should not be taken lightly so as not to occur dissatisfaction among villagers. Therefore, the park management party should be sensitive to this situation in order to maintain the welfare of the villagers and at the same time giving satisfaction to the tourists who enjoy ecotourism activities there.

scholarly journals The Ramifications of Covid-19 Within the African American Community

2021 ◽  
Vol 2 (4) ◽  
pp. 15-26
Author(s):  
Libby Goodman ◽  
Fayetta Lake ◽  
Chinyere Maureen Ndu
Keyword(s):  
African American ◽  
African Americans ◽  
Mortality Rates ◽  
African American Community ◽  
Current Policy ◽  
African American Culture ◽  
African American Population ◽  
General Article ◽  
Perceived Reasons ◽  
Healthcare Leaders

The coronavirus (Covid-19) perplexed many aspects of everyday life. Sadly, Covid-19 took a greater toll on African Americans. As Covid-19 developed, medical professionals, health care authorities, and advocates recognized several day-to-day living situations and intrinsic medical conditions that distressed African Americans with higher mortality rates during the pandemic. It is imperative that healthcare leaders understand the ramifications that have occurred and that may continue to surface from the Covid-19 affliction, which could be utilized to adjust and amend current policy surrounding the adversely affected African American population. We explored several substantial questions regarding this pandemic: the perceived reasons for the vast impact of Covid-19 within the African American culture; and what recommendations are needed to aid healthcare leaders in the fight against Covid-19 within the African American community. There are six ramifications that the authors address in this general article, including- employment, poverty, deaths, mental illness, and distrust. We offer suggestions to implement, prevent, and educate the African American public to circumvent these ramifications for present and future pandemics.

scholarly journals Maternal mortality-a three-year retrospective study in a rural medical college of India

2021 ◽  
Vol 10 (8) ◽  
pp. 3019
Author(s):  
Jayasree Hansda ◽  
Debobroto Roy ◽  
Krishnapada Das ◽  
Manojit Sarkar ◽  
Rumpa Das ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Tertiary Care Centre ◽  
Maternal Deaths ◽  
Demographic Profiles ◽  
Medical College ◽  
Mortality Ratio ◽  
Tragic Event

Background: Maternal mortality is a tragic event as family revolves around a mother. The deadly obstetrical triad of hemorrhage, preeclampsia and infection has accounted for a third of all deaths. This study was conducted to assess maternal mortality ratio, demographic profile and causes of maternal death.Methods: This retrospective longitudinal study was conducted in the department of obstetrics and gynecology for a period of three years from 1st January 2018-31st December, 2020. Total no of death during this period was 134.Records of deaths and demographic profiles were retrieved from the medical record library of aforesaid hospital.Results: There were 134 maternal deaths amongst 56815 live births with MMR 235.85. The majority of deaths were in 20-29 year of age group and most of the deaths seen in multigravida. The 91.79% death was observed within the 24 hours and after 72 hours. Eclampsia, preeclampsia and hemorrhage were leading cause of maternal death seen in the study.Conclusions: Maternal mortality is higher than national MMR. Majority of maternal death were preventable by proper antenatal care, early detection of high-risk pregnancies and their timely referral to tertiary care centre.

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