scholarly journals A mobile cesarean birth center as a solution to improve access to surgical birth in rural Ethiopia: a mixed methods research protocol

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Margo S. Harrison ◽  
Teklemariam Yarinbab ◽  
Brooke Dorsey-Holliman ◽  
Gregory A. Aarons ◽  
Ana Pilar Betran ◽  
...  
Keyword(s):  
Mixed Methods Research ◽  
Emergency Obstetric Care ◽  
Public Health Problem ◽  
Neonatal Morbidity ◽  
Obstetric Care ◽  
Healthcare Intervention ◽  
User Centered Design ◽  
Birth Center ◽  
Cesarean Birth ◽  
Operative Care

Abstract Background As an evidence-based intervention to prevent maternal and neonatal morbidity and mortality, cesarean birth at rates of under 2%, which is the case in rural Southwest Ethiopia, is an unacceptable public health problem and represents an important disparity in the use of this life-saving treatment compared to more developed regions. The objective of this study is to explore an innovative clinical solution (a mobile cesarean birth center) to low cesarean birth rates resulting from the Three Delays to emergency obstetric care in isolated and underserved regions of Ethiopia, and the world. Methods We will use mixed but primarily qualitative methods to explore and prepare the mobile cesarean birth center for subsequent implementation in communities in Bench Sheko and West Omo Zones. This will involve interviews and focus groups with key stakeholders and retreat settings for user-centered design activities. We will present stakeholders with a prototype surgical truck that will help them conceive of the cesarean birth center concept and discuss implementation issues related to staffing, supplies, referral patterns, pre- and post-operative care, and relationship to locations for vaginal birth. Discussion Completion of our study aims will allow us to describe participants’ perceptions about barriers and facilitators to cesarean birth and their attitudes regarding the appropriateness, acceptability, and feasibility of a mobile cesarean birth center as a solution. It will also result in a specific, measurable, attainable, relevant, and timely (SMART) implementation blueprint(s), with implementation strategies defined, as well as recruitment plans identified. This will include the development of a logic model and process map, a timeline for implementation with strategies selected that will guide implementation, and additional adaptation/adjustment of the mobile center to ensure fit for the communities of interest. Trial registration There is no healthcare intervention on human participants occurring as part of this research, so the study has not been registered.

scholarly journals A mobile caesarean birth center as a solution to improve access to surgical birth in rural Ethiopia: a mixed methods research protocol

2021 ◽  
Author(s):  
Margo S Harrison ◽  
Teklemariam Yarinbab ◽  
Brooke Dorsey-Holliman ◽  
Gregory Aarons ◽  
Ana Pilar Betran ◽  
...  
Keyword(s):  
Mixed Methods Research ◽  
Emergency Obstetric Care ◽  
Implementation Strategies ◽  
Public Health Problem ◽  
Neonatal Morbidity ◽  
Obstetric Care ◽  
User Centered Design ◽  
Birth Center ◽  
Cesarean Birth ◽  
Operative Care

Abstract Background As an evidence-based intervention to prevent maternal and neonatal morbidity and mortality, cesarean birth at rates of under 2%, which is the case in rural Southwest Ethiopia, is an unacceptable public health problem and represents an important disparity in use of this life-saving treatment compared to more developed regions. The objective of this study is to explore an innovative clinical solution (a mobile cesarean birth center) to low cesarean birth rates resulting from the Three Delays to emergency obstetric care in isolated and underserved regions of Ethiopia, and the world. Methods We will used mixed but primarily qualitative methods to explore and prepare the mobile cesarean birth center for subsequent implementation in communities in Bench Sheko and West Omo Zones. This will involve interviews and focus groups with key stakeholders and retreat settings for user-centered design activities. We will present stakeholders with a prototype surgical truck that will help them conceive of the cesarean birth center concept and discuss implementation issues related to staffing, supplies, referral patterns, pre- and post-operative care, and relationship to locations for vaginal birth. Discussion Completion of our study aims will allow us to describe participants’ perceptions about barriers and facilitators to cesarean birth and their attitudes regarding the appropriateness, acceptability, and feasibility of a mobile cesarean birth center as a solution. It will also result in a specific, measurable, attainable, relevant, and timely (SMART) implementation blueprint(s), with implementation strategies defined, as well as recruitment plans identified. This will include the development of a logic model and process map, a timeline for implementation with strategies selected that will guide implementation, and additional adaptation/adjustment of the mobile center to ensure fit for the communities of interest.

scholarly journals Obstetric Fistula: The Agony of Unsafe Motherhood. A Review of Nigeria Experience

2019 ◽  
pp. 1-7
Author(s):  
C. O. Njoku ◽  
A. N. Njoku
Keyword(s):  
Obstetric Fistula ◽  
Relevant Literature ◽  
Emergency Obstetric Care ◽  
Public Health Problem ◽  
Obstetric Care ◽  
Sub Saharan Africa ◽  
Medical Attention ◽  
Additional Information ◽  
Sub Saharan ◽  
Google Search

Obstetric fistula is a dehumanizing complication of childbirth that has severe psychosocial impact; though almost non-existing in developed nations, it is still a public health problem in Nigeria and other countries in sub-Saharan Africa. In Nigeria, about 100,000–1,000,000 women are living with obstetric fistula and estimated 50,000-100,000 new cases occur annually. To review the relevant literature on obstetric fistula in Nigeria, literature search was carried on epidemiology, prevalence, risk factors, causes, reasons for delay in intervention, complications and preventions using Google search. Additional information was obtained from text and journal in medical library of University of Calabar library. The main cause of obstetric fistula in Nigeria is prolonged obstructed labour, which most often occur due to delay in seeking medical attention because of social and financial reasons. Other causes include inadequate facilities for emergency obstetric services, especially caesarean section, poor access to existing ones, and delay in intervention on reaching the health facilities as a result of limited number of skilled obstetric personnel and/or equipments. There is need to increase collaboration and education of local communities on the cultural and social factors that influence and increase risk of obstetric fistula as well as improving the health-system’s response to emergency obstetric care.

scholarly journals Female Community Health Volunteers’ (FCHVs) Involvement in Improving Maternal Health, Nepal

2019 ◽  
Vol 2 (3) ◽  
pp. 250-252 ◽  
Author(s):  
Prakash Shahi
Keyword(s):  
Maternal Health ◽  
National Policy ◽  
Family Health ◽  
Emergency Obstetric Care ◽  
Skilled Birth Attendant ◽  
Neonatal Morbidity ◽  
Obstetric Care ◽  
Safe Motherhood ◽  
Care Services ◽  
Policies And Programs

Improving maternal health was one of the eight millennium development goals (MDGs) in 2000 and later included in SDG as a major agenda in 2015 which was adopted by the international community.  In Nepal, the first elected democratic government developed Health Policy in 1991 and revised in 2014 which has identified safe motherhood as a priority program and institutionalized safe motherhood as a primary health care. In order to effectively address maternal and neonatal morbidity and mortality, the Family Health Division, Department of Health Services (DoHS) developed National Safe Motherhood Long Term Plan 2002- 2017 (revised in 2006) which aimed to establish basic and comprehensive emergency obstetric care services in all districts. To complement this plan, the National Policy on SBA (2006) was developed with the aim of increasing the percentage of births assisted by a skilled birth attendant (as internationally defined) to 60 percent by 2015. Table 1 explains some historical shifts in maternal health policies and programs in Nepal.

Risk perception on the labour ward: A mixed methods study

2021 ◽  
Vol 26 (2) ◽  
pp. 56-63
Author(s):  
Claire McCarthy ◽  
Sarah Meaney ◽  
Marie Rochford ◽  
Keelin O’Donoghue
Keyword(s):  
Mixed Methods ◽  
Lived Experience ◽  
Healthcare Providers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Daily Basis ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Staff Support ◽  
Staff Wellbeing

Healthcare providers commonly experience risky situations in the provision of maternity care, and there has been increased focus on the lived experience in recent years. We aimed to assess opinions on, understanding of and behaviours of risk on the LW by conducting a mixed methods study. Staff working in a LW setting completed a descriptive questionnaire-based study, followed by qualitative structured interviews. Statistical analysis was performed with SPSS on quantitative data and thematic analysis performed on qualitative data. Nearly two thirds of staff (64%; 73/114) completed the questionnaire, with 56.2% (n = 47) experiencing risk on a daily basis. Experiencing risk evoked feelings of apprehension (68.4%; n = 50) and worry (60.2%; n = 44) which was echoed in the qualitative work. Structured clinical assessment was utilised in risky situations, and staff described “ going on autopilot” to manage these situations. A large number of respondents reflected on their provision of care following an adverse event (87.7%; n = 64). Debriefing was mentioned as an important practice following such events by all respondents. This study describes the negative terminology prevailing in emergency obstetric care. These experiences can have a profound impact on staff. Risk reduction strategies and the provision of increased staff support and training are crucial to improve staff wellbeing in stressful scenarios.

scholarly journals Incidence and Determinants of Newborn Mortality in the First Three Days of Delivery in Northwestern Ethiopia: A Prospective Cohort Study

2021 ◽  
Author(s):  
Mulugeta Worke ◽  
Afework Mekonnen ◽  
Simachew Limeneh
Keyword(s):  
Cohort Study ◽  
Neonatal Mortality ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Care Quality ◽  
Antenatal Visit ◽  
Maternal Complications ◽  
Newborn Mortality

Abstract Background: Addressing the target of sustainable development goals of reducing perinatal mortality was still a global challenge, and it is a concern in Ethiopia. Therefore, this study planned to determine the incidence and determinants of neonatal mortality in the first three days among babies delivered in Amhara Regional State’s referral hospitals. Methods: A hospital-based prospective cohort study design was conducted among 810 neonates in the first three days of delivery between March 1 and August 30, 2018. The neonates were followed, starting from the time of admission to 72 hours. An interviewer-administered questionnaire and medical record review were conducted for data collection. Data were entered into Epi-data manager version 4.4 and analyzed using STATA™ version 16.0 for the analysis. Cox-Proportional hazard model was used to determine the survival time of the newborns. Results: The overall incidence of newborn mortality in this study was 151/1,000 births. Neonatal mortality was significantly high among newborns whose mothers came between 17 and 28 weeks of gestation for the first visit; among those whose mothers labour was not monitored with a partograph, mothers experience postpartum haemorrhage, develop fistula in the first 24 hours, and experience obstructed labour. However, 39% were less risky among newborns whose mothers were directly admitted and whose mothers had visited health facilities in less than 1-hour, both. Conclusions: This study revealed that about 1 in 7 newborns died in the early three days of life. Timing of the first antenatal visit, quality of labour monitoring, maternal complications, and delay in seeking the care were the determinants. Thus, scaling-up of evidence-based interventions and harmonized efforts to improve antenatal care quality, promote institutional deliveries, provide optimal essential and emergency obstetric care, and ensure immediate postnatal care may improve neonatal survival.

scholarly journals MATERNAL MORTALITY

2009 ◽  
Vol 16 (01) ◽  
pp. 135-138
Author(s):  
TASNIM TAHIRA REHMAN ◽  
MAHNAZ ROOHI
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Maternal Mortality Ratio ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Care Level ◽  
Maternal Deaths ◽  
Mortality Ratio ◽  
Study Setting ◽  
Very High

Objective: To find out maternal mortality ratio (MMR) and to determine major causes of maternal death. S t u d y d e s i g n:A descriptive study. Setting: Department of Obstetric and Gynaecology, Allied Hospital, Faisalabad. S t u d y period: From 01.01.2008 to31.12.2008. Materials a n d m e t h o d s : All cases of maternal death during this study periods were included except accidental deaths. Results:There were 58 maternal deaths during this period. Total No. of live births were 5975. MMR was 58/5975 x 100,000 = 970/100,000 live births.The most common cause of maternal death was hemorrhage (34.5%) followed by hypertensive disorders/eclampsia (31%). Most of thepatients (75.86%) were referred from primary & secondary care level. C o n c l u s i o n : Maternal mortality is still very high in underdevelopedcountries including Pakistan. We must enhance emergency obstetric care (EOC) to achieve the goal of reduction in MMR.

scholarly journals Factors affecting stillbirth: prospective study

2021 ◽  
Vol 10 (3) ◽  
pp. 939
Author(s):  
Balaji Jadhav ◽  
Shweta Avinash Khade ◽  
Ganesh Shinde ◽  
Shilpa Chandan
Keyword(s):  
Antenatal Care ◽  
Gestational Age ◽  
Prospective Observational Study ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Tertiary Hospital ◽  
Fetal Weight ◽  
Factors Affecting ◽  
Medical Disorders ◽  
Number Of Births

Background: Stillbirth is defined by WHO as the birth of a baby with a birth weight of 500 gm or more, 22 or more completed weeks of gestation or a body length of 25 cm or more, who died before or during labour and birth.Methods: This was prospective observational study of factors affecting stillbirth was conducted in tertiary hospital for a period of 1 year from 1st June 2014 to 31st May 2015. During the study period, 200 parturient of gestational age 28 weeks or more and fetal weight 1000 gm or more with or without medical disorders were included.Results: The total number of births during study period was 11,951. Stillbirth rate in the present study was 16.73 per 1000 births. Most of stillbirths were seen in the antepartum period (76%) when compared to intrapartum period (24%). Maximum stillbirths occurred in gestational age of 36 weeks and above (52%) and fetal weight between 2001-2500 gm (27.50%). Patients with inadequate antenatal care, less than three visits had 86% stillbirths.Conclusions: Proper antenatal care, prompt referral services and availability of emergency obstetric care will provide a pivotal role for reduction of stillbirths.

Sign in / Sign up

Export Citation Format

Share Document