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.

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.

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.

scholarly journals Gambaran kematian maternal di RSUP Prof. Dr. R. D. Kandou Manado 1 Januari 2013 – 31 Desember 2015

e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Mustika S. Lumbanraja ◽  
Hermie M.M. Tendean ◽  
Maria Loho
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Age Group ◽  
Health Issues ◽  
Maternal Deaths ◽  
Working Mother ◽  
The Status ◽  
Using Data ◽  
And Child Health

Abstract: Maternal death is the death of a pregnant woman or death within 42 days after the termination of pregnancy, irrespective of the length and location of the pregnancy, caused by anything related to pregnancy, or aggravated by the pregnancy or its handling, but not the death caused by accident or accidentally. Maternal mortality is one of the indicators to evaluate the progress of the health of a country, especially those related to maternal and child health issues. This study was aimed to determine the characteristics of maternal death. This was a descriptive retrospective study using data of the Medical Record Department of Prof. Dr. R. D. Kandou Manado from 1 January 2013 to 31 December 2015. In this study, there were 41 cases of maternal deaths. In 2013 and 2014, the highest death rate was in the age group >35 years, while in 2015 in the age group 20-25 years. Based on the number of parity, the highest mortality rates in the number of parity 2-3 in 2013 and 2014, while in 2015 the number of parity ≤1. The highest mortality rate by level of education was high school educated. Based on employment status, the highest mortality rate was in the group of working mother. The highest death toll was based on marital status in the group who are married. Based on the status of the referral highest mortality rate was in status is not a referral. This study found that the highest cause of maternal mortality is three consecutive years eclampsia, sepsis, eclampsia. Conclusion: Of 41 cases of maternal deaths in the Department of Prof. Dr. R. D. Kandou Manado for 3 years, the most cause of death was due to eclampsia/pre-eclampsia which was 4-7 cases each year. Maternal mortality rate per 100000 live births yearly in sequence were 373, 427, 789.Keywords: maternal death Abstrak: Kematian maternal adalah kematian wanita yang terjadi saat hamil atau dalam 42 hari setelah berakhirnya kehamilan, tidak tergantung dari lama dan lokasi kehamilan, disebabkan oleh apapun yang berhubungan dengan kehamilan, atau yang diperberat oleh kehamilan tersebut atau penanganannya, tetapi bukan kematian yang disebabkan oleh kecelakaan atau kebetulan. Kematian maternal merupakan salah satu indikator untuk melihat kemajuan kesehatan suatu negara, khususnya yang berkaitan dengan masalah kesehatan ibu dan anak. Penelitian ini bertujuan untuk mengetahui gambaran kematian maternal. Jenis penelitian ini ialah deskriptif retrospektif menggunakan rekam medik di RSUP Prof. Dr. R. D. Kandou Manado periode 1 Januari 2013-31 Desember 2015. Pada penelitian ini, ditemukan 42 kasus kematian maternal. Pada tahun 2013 dan 2014 angka kematian tertinggi di kelompok usia >35 tahun, sedangkan tahun 2015 ditemukan di kelompok usia 20-25 tahun. Berdasarkan jumlah paritas, angka kematian tertinggi pada jumlah paritas 2-3 di tahun 2013 dan 2014, sedangkan untuk tahun 2015 pada jumlah paritas ≤1. Angka kematian tertinggi berdasarkan tingkat pendidikan ialah SMA. Berdasarkan status pekerjaan, angka kematian tertinggi berada pada kelompok ibu yang bekerja. Angka kematian tertinggi berdasarkan status pernikahan berada pada kelompok yang sudah menikah. Berdasarkan status rujukan angka kematian yang tertinggi ialah pada status bukan rujukan. Pada penelitian ini ditemukan penyebab kematian ibu yang tertinggi 3 tahun berurutan ialah pre-eklampsia/eklampsia, infeksi, pre-eklampsia/eklampsia. Simpulan: Jumlah kematian maternal di RSUP Prof. Dr. R. D. Kandou Manado selama 3 tahun yaitu sebanyak 41 kasus. Penyebab kematian terbanyak disebabkan oleh eklampsia/pre-eklampsia yaitu 4-7 kasus per tahun. Angka kematian ibu per 100000 kelahiran hidup per tahun berurutan ialah 373, 427, 789. Kata kunci: kematian maternal

scholarly journals PERBEDAAN TINGKAT PENGETAHUAN TENTANG KEHAMILAN SEHAT DENGAN INDIKATOR KESEHATAN IBU HAMIL YANG MENGIKUTI KELAS IBU HAMIL

2019 ◽  
Vol 6 (1) ◽  
pp. 1-8
Author(s):  
Sri Mumpuni Yuniarsih ◽  
Anik Indriono ◽  
Siwi Sri Widhowati
Keyword(s):  
Blood Pressure ◽  
Weight Gain ◽  
Mortality Rate ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Health Indicators ◽  
Data Retrieval ◽  
Maternal Mortality Rate ◽  
Antenatal Visits

Background: Maternal Mortality Rate (MMR) in Indonesia is still one of the highest in Southeast Asia (ASEAN). World Health Organization (WHO) as the international organization is targeting a decrease in the (MMR) as one of the targets in the achievement of the Millennium Development Goals (MDGs). However, based on the evaluation of part-time Development Plan 2010-2014, the target of reducing maternal mortality rate in Indonesia is still very difficult to achieve. One of the government's efforts to accelerate the decline of maternal mortality rate is a mother class program. Objective: This study aimed to analyze the achievement of the indicators of maternal health program in comparison with the class of pregnant women who do not attend pregnant women class. Methods: This research was a quantitative research with cross sectional design that compared the achievement of the nine indicators of the health of pregnant women in the two groups of pregnant women. The variable in this study was a comparison of weight gain, blood pressure, upper arm circumference (MUAC), high fundus, fetal heart rate (FHR), the consumption of iron tablets, hemoglobin levels, antenatal visits, and knowledge about healthy pregnancies. The number of samples in this study were 209 respondents which were divided into groups of 86 respondents in a class of pregnant women and 123 respondents in the non-class group of pregnant women. Chi square and t test was used to analyze the comparison of maternal health indicators achievement advance of two groups of respondents. Results and Discussion: The results showed that there were significant difference in knowledge about a healthy pregnancy, the consumption of iron tablet and number of antenatal visits. Pregnant women who attended classes had a better knowledge, more Fe tablet consumption and ANC visit. While indicators of weight gain, MUAC, TFU and DJJ of all respondents were within the normal range according to gestational age when the data retrieval. The other indicators such as hemoglobin level, systolic and diastolic blood pressure did not reveal any significant differences between the two groups of respondents. Keywords: Mother class program; maternal health indicators

scholarly journals Mengenal Tanda-Tanda Bahaya Kehamilan di Puskesmas Pakuan Baru Kota Jambi

2021 ◽  
Vol 3 (1) ◽  
pp. 52
Author(s):  
Ria Febrina
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Community Service ◽  
Health Workers ◽  
Obstetric Complications ◽  
Maternal Deaths ◽  
Maternal Mortality Rate ◽  
Live Births ◽  
Danger Signs

Maternal Mortality Rate (MMR) in Indonesia is still high compared to other ASEAN countries. MMR in Indonesia according to the 2017 Indonesian Demographic and Health Survey (IDHS) is 305 per 100,000 live births. The global target of SDGs (Suitainable Development Goals) is to reduce the Maternal Mortality Rate (MMR) to 70 per 100,000 live births. While in Jambi Province in 2017 recorded maternal deaths were 29 cases. Maternal deaths that occur during 90% of pregnancy are caused by obstetric complications. Direct obstetric complications are bleeding, infection and eclampsia. Indirectly maternal mortality is also influenced by delays at the family level in recognizing danger signs of pregnancy and making decisions to immediately seek help. Delay in reaching health facilities and assistance in health service facilities. Pregnancy danger signs must be recognized and detected early so that they can be handled properly because any danger signs of pregnancy can lead to pregnancy complications. Therefore it is necessary to provide counseling to improve the knowledge of pregnant women about the danger signs of pregnancy. This community service activity was carried out by Pakuan Baru Kota Jambi Public Health Center. The time of implementation in April 2020. The target is pregnant women. Community service methods include a survey and lecture approach. The results obtained are pregnant women able to understand the danger signs of pregnancy. It is recommended for health workers to continue to provide education related to pregnancy to pregnant women

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.

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.

Historical and Recent Changes in Maternal Mortality Due to Hypertensive Disorders in the United States, 1979 to 2018

Hypertension ◽  
2021 ◽  
Vol 78 (5) ◽  
pp. 1414-1422
Author(s):  
Cande V. Ananth ◽  
Justin S. Brandt ◽  
Jennifer Hill ◽  
Hillary L. Graham ◽  
Sonal Grover ◽  
...  
Keyword(s):  
United States ◽  
Mortality Rate ◽  
Maternal Mortality ◽  
Birth Cohort ◽  
White Women ◽  
Gestational Hypertension ◽  
The United States ◽  
Chronic Hypertension ◽  
Maternal Deaths ◽  
Live Births

We evaluated the contributions of maternal age, year of death (period), and year of birth (cohort) on trends in hypertension-related maternal deaths in the United States. We undertook a sequential time series analysis of 155 710 441 live births and 3287 hypertension-related maternal deaths in the United States, 1979 to 2018. Trends in pregnancy-related mortality rate (maternal mortality rate [MMR]) due to chronic hypertension, gestational hypertension, and preeclampsia/eclampsia, were examined. MMR was defined as death during pregnancy or within 42 days postpartum due to hypertension. Trends in overall and race-specific hypertension-related MMR based on age, period, and birth cohort were evaluated based on weighted Poisson models. Trends were also adjusted for secular changes in obesity rates and corrected for potential death misclassification. During the 40-year period, the overall hypertension-related MMR was 2.1 per 100 000 live births, with MMR being almost 4-fold higher among Black compared with White women (5.4 [n=1396] versus 1.4 [n=1747] per 100 000 live births). Advancing age was associated with a sharp increase in MMR at ≥15 years among Black women and at ≥25 years among White women. Birth cohort was also associated with increasing MMR. Preeclampsia/eclampsia-related MMR declined annually by 2.6% (95% CI, 2.2–2.9), but chronic hypertension–related MMR increased annually by 9.2% (95% CI, 7.9–10.6). The decline in MMR was attenuated when adjusted for increasing obesity rates. The temporal burden of hypertension-related MMR in the United States has increased substantially for chronic hypertension–associated MMR and decreased for preeclampsia/eclampsia-associated MMR. Nevertheless, deaths from hypertension continue to contribute substantially to maternal deaths.

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.

Geographic access and maternal health services utilization in Sélingué Health District, Mali.

2020 ◽  
Author(s):  
Moctar TOUNKARA ◽  
Oumar Sangho ◽  
Madeleine Beebe ◽  
Lillian Joyce Whiting-Collins ◽  
Rebecca R. Goins ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Maternal Mortality ◽  
Health Facility ◽  
Health Services Utilization ◽  
Maternal Health Services ◽  
Health District ◽  
Geographic Access ◽  
Services Utilization ◽  
The Impact

Abstract Introduction. Maternal mortality is one of the main causes of death for women of childbearing age in Mali, and improving this outcome is slow, even in high geographic-access regions. Disparities in maternal health services utilization can constitute a major obstacle in the reduction of maternal mortality and denotes a lack of equity in the Malian health system.Literature on maternal health inequity has explored structural and individual factors influencing outcomes but has not examined inequities in health facility distribution within moderate geographic access districts in Mali. The purpose of this article is to examine disparities in education and geographic distance and how they affect utilization of maternal care within the Sélingué health district, a district with moderate geographic access to care, near Bamako, Mali.Methods. We conducted a cross sectional survey with cluster sampling in the Sélingué health district. Maternal health services characteristics and indicators were described. Association between dependent and independent variables was verified using Kendall’s tau-b correlation, Chi square, logistic regression with odds ratio and 95% confidence interval. Gini index and concentration curve were used to measure inequity.Results. The majority of the participants were 20 to 24 years old. Over 68% of our sample had some education, 65% completed at least four ANC visits, and 60.8% delivered at a health facility. Despite this evidence of healthcare access in Sélingué, disparities within the health district impede the other roughly 40% of our sample from utilizing maternal healthcare. The concentration index demonstrated the impact of inequity in geographic access comparing women residing near and far from the referral care facility.Conclusion. Maternal health services underutilization, within a district with moderate geographic access, indicates that deliberate attention should be paid to addressing geographic access even in such a district.

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