scholarly journals Actors Affecting the Decrease of Maternal Mortality Rates and Problems Related to Birth Services

2018 ◽  
Vol 13 (3) ◽  
pp. 331-337
Author(s):  
Dewi Sari Rochmayani
Keyword(s):  
Health Services ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Community Health Center ◽  
Professional Organizations ◽  
Theory Approach ◽  
Live Births ◽  
Referral Hospitals ◽  
Obstetric Services ◽  
Grounded Theory Approach

The targeted 102 per 100,000 live births maternal mortality rate (AKI) in Semarang has not been achieved yet. In the era of childbirth insurance program in 2011, AKI reached 119.9 per 100,000. Then, in the era of National Health Insurance (JKN) by Social Security Administrator (BPJS), the AKI in 2004 was 109,2 per 100.000 live births. The study design was qualitative with grounded theory approach. There were 4 research focuses: 1) actors who contribute in labor services; 2) referral delay; 3) Community Health Center (Puskesmas) with basic essential obstetric–neonatal service (Poned); 4) profile of each obstetric services level in Semarang. The results showed that there were 2 groups of actors who contributed to prevention of maternal death. The first group were obstetrics and gynecologists, health surveyors, and professional organizations. The second group were family and society, including husband, mother, in-laws, and public figures. Many maternal death occurred in referral hospitals. There are three types of delay that often occur in Semarang, namely delay in decision-making, delay in accessing health services, and delay in acquiring health services.

The Untold Story: How the Health Care Systems in Developing Countries Contribute to Maternal Mortality

1992 ◽  
Vol 22 (3) ◽  
pp. 513-528 ◽  
Author(s):  
T. K. Sundari
Keyword(s):  
Health Care ◽  
Developing Countries ◽  
Health Services ◽  
Maternal Mortality ◽  
Health Care Systems ◽  
Health Services Delivery ◽  
Services Delivery ◽  
Life Saving ◽  
Referral Hospitals ◽  
Care Systems

This article attempts to put together evidence from maternal mortality studies in developing countries of how an inadequate health care system characterized by misplaced priorities contributes to high maternal mortality rates. Inaccessibility of essential health information to the women most affected, and the physical as well as economic and sociocultural distance separating health services from the vast majority of women, are only part of the problem. Even when the woman reaches a health facility, there are a number of obstacles to her receiving adequate and appropriate care. These are a result of failures in the health services delivery system: the lack of minimal life-saving equipment at the first referral level; the lack of equipment, personnel, and know-how even in referral hospitals; and worst of all, faulty patient management. Prevention of maternal deaths requires fundamental changes not only in resource allocation, but in the very structures of health services delivery. These will have to be fought for as part of a wider struggle for equity and social justice.

scholarly journals Zero Maternal Death with KECUBUNG Featured in SATE Krembung Application (Integrated Queue System) in Krembung Community Health Center in 2017 until 2018

2020 ◽  
Vol 4 (1) ◽  
pp. 59
Author(s):  
Arif Rahman Nurdianto
Keyword(s):  
High Risk ◽  
Early Detection ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Health Center ◽  
Maternal Death ◽  
Community Health Center ◽  
Work Area ◽  
Special Programs ◽  
And Child Health

ABSTRACTThere are some special programs in Maternal and Child Health that have not yet been reached and have a bad trend like the number of Low Birth Weight (LBW), cases of stillbirth, and babies died. There was a congenital defect in babies, increased obstetric complications, and there is one case of maternal death. There were neo-complications in infants and babies. The problem that often results in the death of pregnant women is the lack of early detection at first-level facilities in the Krembung Health center. Early detection and treatment or planning in cases of high-risk pregnant women is lacking, and then we created a SATE Krembung application in 2017. Making SATE Krembung application, socializing to the community, socializing the features of KECUBUNG to report mothers at high risk, and bringing services closer to the community and to evaluate reports from residents. Activities are collected, analyzed, and processed into mature data. The number of people activities collected during the collection of data during this research from 500 users of application from 2017 until 2018. There was a decrease in maternal mortality rates to zero patients in 2017 and 2018. The use of SATE Krembung is quite effective in reducing maternal mortality to zero patients in the Krembung health center work area, but this must be improved with the development of applications. The application of SATE Krembung with KECUBUNG feature can reduce maternal mortality by empowering health cadres and the community to be aware of the environmental conditions surrounding them.Keywords                   : SATE Krembung, KECUBUNG, Maternal Death

scholarly journals PEREMPUAN DAN KESEHATAN REPRODUKSI

EGALITA ◽  
2012 ◽  
Author(s):  
Imamah Imamah
Keyword(s):  
Mortality Rate ◽  
Health Services ◽  
Maternal Mortality ◽  
Human Development ◽  
Access To Information ◽  
Live Births ◽  
Human Development Report ◽  
Mothers And Children ◽  
Mother And Child ◽  
The Government

In terms of Indonesian women’s health services are still treated unfairly and still are the number two. It can be seen from the report reporting Indonesia Human  Development Report 2005 on maternal mortality rate (MMR) delivery, which is currently listed at number 307 out of every 100,000 live births. This shows that the government has not seriously and equitable in the provision of health services particularly for women. Maternal mortality can be used as indicators of poor health services received by mothers and children and low access to information owned by mother and child.<br /><br />Keywords: Perempuan, Human Development Report, Angka Kematian Ibu, Indikator dan Kesehatan.<br /><br />

scholarly journals Incidence of maternal near-miss in Kenya in 2018: findings from a nationally representative cross-sectional study in 54 referral hospitals

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Onikepe Owolabi ◽  
Taylor Riley ◽  
Kenneth Juma ◽  
Michael Mutua ◽  
Zoe H. Pleasure ◽  
...  
Keyword(s):  
Maternal Health ◽  
Maternal Mortality ◽  
Obstetric Care ◽  
Near Miss ◽  
World Health ◽  
Maternal Near Miss ◽  
Live Births ◽  
Management Of Complications ◽  
Referral Hospitals ◽  
Nationally Representative

Abstract Although the Kenyan government has made efforts to invest in maternal health over the past 15 years, there is no evidence of decline in maternal mortality. To provide necessary evidence to inform maternal health care provision, we conducted a nationally representative study to describe the incidence and causes of maternal near-miss (MNM), and the quality of obstetric care in referral hospitals in Kenya. We collected data from 54 referral hospitals in 27 counties. Individuals admitted with potentially life-threatening conditions (using World Health Organization criteria) in pregnancy, childbirth or puerperium over a three month study period were eligible for inclusion in our study. All cases of severe maternal outcome (SMO, MNM cases and deaths) were prospectively identified, and after consent, included in the study. The national annual incidence of MNM was 7.2 per 1,000 live births and the intra-hospital maternal mortality ratio was 36.2 per 100,000 live births. The major causes of SMOs were postpartum haemorrhage and severe pre-eclampsia/eclampsia. However, only 77% of women with severe preeclampsia/eclampsia received magnesium sulphate and 67% with antepartum haemorrhage who needed blood received it. To reduce the burden of SMOs in Kenya, there is need for timely management of complications and improved access to essential emergency obstetric care interventions.

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.

scholarly journals A study to assess proportion of the maternal near miss to maternal death in a tertiary care teaching hospital of North East India

2020 ◽  
Vol 9 (6) ◽  
pp. 2486
Author(s):  
Pradip Sarkar ◽  
Jahar Lal Baidya ◽  
Ashis Kumar Rakshit
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Maternal Deaths ◽  
Live Births ◽  
Medical Disorders ◽  
Mortality Ratio

Background: The objective of present study was to assess the proportion of maternal near miss and maternal death and the causes involved among patients attending obstetrics and gynaecology department of Agartala Govt. Medical College of North Eastern India.Methods: Potentially life-threatening conditions were diagnosed, and those cases which met WHO 2009 criteria for near miss were selected. Maternal mortality during the same period was also analyzed. Patient characteristics including age, parity, gestational age at admission, booked, mode of delivery, ICU admission, duration of ICU stay, total hospital stay and surgical intervention to save the life of mother were considered. Patients were categorized by final diagnosis with respect to hemorrhage, hypertension, sepsis, dystocia (direct causes) anemia, thrombocytopenia, and other medical disorders were considered as indirect causes contributing to maternal near miss and deaths.Results: The total number of live births during the study period (January 2017 to June, 2018) was 9378 and total maternal deaths were 37 with a maternal mortality ratio of 394.5/1 lakh live births. Total near miss cases were 96 with a maternal near miss ratio of 10.24/1000 live births. Maternal near miss to mortality ratio was 2.6. Of the 96 maternal near miss cases - importantly 20.8% were due to haemorrhage, 19.8% were due to hypertension, 13.5% were due to sepsis, and 11.5% were due to ruptured uterus. In maternal death group (n-37), most important causes were hypertensive (40.5%) followed by septicemia (21.6%), haemorrhage (10.8).Conclusions: Haemorrhage, hypertensive disorders and sepsis were the leading causes of near miss events as well as maternal deaths.

scholarly journals Estimating Maternal Mortality Level in Rural Northern Nigeria by the Sisterhood Method

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Henry V. Doctor ◽  
Sally E. Findley ◽  
Godwin Y. Afenyadu
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Maternal Mortality Ratio ◽  
Lifetime Risk ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Northern Nigeria ◽  
Maternal Deaths ◽  
Live Births ◽  
Sisterhood Method

Maternal mortality is one of the major challenges to health systems in sub Saharan Africa. This paper estimates the lifetime risk of maternal death and maternal mortality ratio (MMR) in four states of Northern Nigeria. Data from a household survey conducted in 2011 were utilized by applying the “sisterhood method” for estimating maternal mortality. Female respondents (15–49 years) were interviewed thereby creating a retrospective cohort of their sisters who reached the reproductive age of 15 years. A total of 3,080 respondents reported 7,731 maternal sisters of which 593 were reported dead and 298 of those dead were maternal-related deaths. This corresponded to a lifetime risk of maternal death of 9% (referring to a period about 10.5 years prior to the survey) and an MMR of 1,271 maternal deaths per 100,000 live births; 95% CI was 1,152–1,445 maternal deaths per 100,000 live births. The study calls for improvement of the health system focusing on strategies that will accelerate reduction in MMR such as availability of skilled birth attendants, access to emergency obstetrics care, promotion of facility delivery, availability of antenatal care, and family planning. An accelerated reduction in MMR in the region will contribute towards the attainment of the Millennium Development Goal of maternal mortality reduction in Nigeria.

scholarly journals History of Maternal Mortality in the City of Ribeirão Preto, in its Regional Health Department, and in the State of São Paulo after the Establishment of the Maternal Committees from 1998 to 2017

2021 ◽  
Author(s):  
Aderson Tadeu Berezowski ◽  
Antonio Luiz Rodrigues Júnior
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Temporal Distribution ◽  
Health Department ◽  
Sao Paulo ◽  
The State ◽  
São Paulo ◽  
Regional Health ◽  
Live Births ◽  
The City

Abstract Objective To describe the evolution of maternal mortality right after the establishment of maternal death committees in the region of the city of Ribeirão Preto, state of São Paulo, Brazil. Methods The present study describes the spatial and temporal distribution of maternal mortality frequencies and rates, using data from the state of São Paulo, the municipality of Ribeirão Preto, and its Regional Health Department (DRS-XIII) from 1998 to 2017. The present ecological study considered the maternal mortality and live birth frequencies made available by the Computer Science Department of the Brazilian Unified Health System (Departamento de Informática do Sistema Único de Saúde, DATASUS, in the Portuguese acronym)/Ministry of Health, which were grouped by year and political-administrative division (the state of São Paulo, the DRS-XIII, and the city of Ribeirão Preto). The maternal mortality rate (MMR) was calculated and presented through descriptive measures, graphs, and cartograms. Results The overall MMR observed for the city of Ribeirão Preto was of 39.1; for the DRS-XIII, it was of of 40.4; and for the state of São Paulo, it was of 43.8 for every 100 thousand live birhts. During this period, the MMR for the city of Ribeirão Preto ranged from 0% to 80% of the total maternal mortalities, and from 40.7% to 47.2% of live births in the DRS-XIII. The city of Ribeirao Preto had an MMR of 76.5 in 1998and 1999, which decreased progressively to 12.1 until the years of 2012 and 2013, and increased to 54.3 for every 100 thousand live births over the past 4 years. The state of São Paulo State had an MMR of 54.0 in 1998–1999, which varied throughout the study period, with values of 48.0 in 2008–2009, and 54.1 for every 100 thousand live births in 2016–2017. Several times before 2015, the city of Ribeirão Preto and the DRS-XIII reached the Millennium Goals. Recently, however, the MMR increased, which can be explained by the improvement in the surveillance of maternal mortality. Conclusion The present study describes a sharp decline in maternal death in the region of Ribeirão Preto by the end of 2012–2013, and a subsequent and distressing increase in recent years that needs to be fully faced.

scholarly journals Maternal Mortality Trends in Spain During the 2000-2018 Period: The Role of Maternal Origin

2021 ◽  
Author(s):  
Santiago García-Tizón Larroca ◽  
Juan Arevalo Serrano ◽  
Maria Ruiz Minaya ◽  
Pilar Paya Martinez ◽  
Ricardo Perez Fernandez Pacheco ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Human Development ◽  
Maternal Death ◽  
Human Development Index ◽  
Descriptive Analysis ◽  
Maternal Origin ◽  
Development Index ◽  
Maternal Mortality Rate ◽  
Live Births

Abstract Backround: The available literature indicates that there are significant differences in maternal mortality according to maternal origin in high income countries. The aim of this study was to examine the trend in the maternal mortality rate and its most common causes in Spain in recent years and to analyse its relationship with maternal origin.Methods: This was a cross-sectional study of all live births as well as those resulting in maternal death in Spain during the period between 2000 and 2018. A descriptive analysis of the maternal mortality rate by cause, region of birth, maternal age, marital status, human development index and continent of maternal origin was performed. The risk of maternal death was calculated using univariate and multivariate logistic regression analyses, with adjustment for certain variables included in the descriptive analysis.Results: There was a total of 293 maternal deaths and 8,439,324 live births during the study period. The most common cause of maternal death was hypertensive disorders of pregnancy. The average maternal death rate was 3.47 per 100,000 live births. The risk of suffering from this complication was higher for immigrant women from less developed countries; therefore, a decrease of 0.01 in the maternal human development index score significantly increased the risk of this complication by 2.4%.Conclusions: The results of this study indicate that there are inequalities in maternal mortality according to maternal origin in Spain. The human development index of the country of maternal origin could be a useful tool when estimating the risk of this complication, taking into account the origin of the pregnant woman.

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