scholarly journals Correction: Scenario modelling as planning evidence to improve access to emergency obstetric care in eastern Indonesia

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261392
Author(s):  
Frederika Rambu Ngana ◽  
A. A. I. N. Eka Karyawati
Keyword(s):  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Eastern Indonesia ◽  
Scenario Modelling ◽  
Improve Access

scholarly journals Scenario modelling as planning evidence to improve access to emergency obstetric care in eastern Indonesia

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0251869
Author(s):  
Frederika Rambu Ngana ◽  
A. A. I. N. Eka Karyawati
Keyword(s):  
Low Income ◽  
Cost Benefit Analysis ◽  
Emergency Obstetric Care ◽  
Cost Benefit ◽  
Obstetric Care ◽  
Benefit Analysis ◽  
Eastern Indonesia ◽  
Scenario Modelling ◽  
Poor Infrastructure ◽  
Improve Access

The rate of maternal deaths in remote areas in eastern Indonesia–where geographic conditions are difficult and the standard of infrastructure is poor–is high. Long travel times needed to reach emergency obstetric care (EMOC) is one cause of maternal death. District governments in eastern Indonesia need effective planning to improve access to EMOC. The aim of this study was to develop a scenario modelling tool to be used in planning to improve access to EMOC in eastern Indonesia. The scenario model was developed using the geographic information system tool in NetLogo. This model has two inputs: the location of the EMOC facility (PONED) and the travel cost of moving across geographical features in the rainy and dry seasons. We added a cost-benefit analysis to the model: cost is the budget for building the infrastructure; benefit is the number of people who can travel to the EMOC in less than 1 hour if the planned infrastructure is built. We introduced the tool to representative midwives from all districts of Nusa Tenggara Timur province and to staff of Kupang district planning agency. We found that the tool can model accessibility to EMOC based on weather conditions; compare alternative infrastructure planning scenarios based on cost-benefit analysis; enable users to identify and mark poor infrastructure; and model travel across the ocean. Lay people can easily use the tool through interactive scenario modelling: midwives can use it for evidence to support planning proposals to improve access to EMOC in their district; district planning agencies can use it to choose the best plan to improve access to EMOC. Scenario modelling has potential for use in evidence-based planning to improve access to EMOC in low-income and lower-middle-income countries with poor infrastructure, difficult geography conditions, limited budgets and lack of trained personnel.

scholarly journals Utilization of Maternity Waiting Home (MWH) to Improve Access to Health Services: Systematic Literature Review

2020 ◽  
Vol 7 (3) ◽  
pp. 368-375
Author(s):  
Nuraina Nuraina
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Health Workers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Access To Health Services ◽  
Care Services ◽  
Access To Health ◽  
Maternity Waiting Home ◽  
Improve Access

Maternity waiting home (MWH) is a home built in the compound or near to health facilities that provides standard medical and emergency obstetric care services. MWH is considered to be a key strategy to "bridge the geographical gap" in obstetric care between rural areas with poor access to equipped facilities, and urban areas where the services are available. This study aimed to systematically review the utilization of MWH to improve access to health service. The method of finding articles in this study was in the period 2014 to 2018, free full text, human species, and scholarly journals which were then identified using an electronic database from Pubmed, Proquest and Onesearch. Three articles were carried out with thematic analysis to identify the main points. Factors associated with the utilization of MWH included (1) Distance; (2) Complication during pregnancy; and (3) Income. Barrier in the utilization of MWH were (1) Inadequate number of room and postpartum bed; (2) Lack of water and sanitation facilities; and (3) Unavailable electricity. Partnership between health workers in rural facilities, stronger role of stakeholders, and a broader health system, were expected to increase the utilization of MWH.

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.

scholarly journals Measuring the preparedness of health facilities to deliver emergency obstetric care in a South African district

PLoS ONE ◽  
2018 ◽  
Vol 13 (3) ◽  
pp. e0194576 ◽  
Author(s):  
Siphiwe Bridget Pearl Thwala ◽  
Duane Blaauw ◽  
Freddie Ssengooba
Keyword(s):  
South African ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Health Facilities
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