Male Role in Emergency Obstetric Care in Rural Niger Delta, Nigeria

2021 ◽  
Vol 19 (2) ◽  
pp. 1-13
Author(s):  
Tarilaifa Akpandara
Keyword(s):  
Reproductive Health ◽  
Maternal Mortality ◽  
Empirical Evidence ◽  
Niger Delta ◽  
Petroleum Industry ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Health Seeking ◽  
Disadvantaged Community ◽  
Male Role

After more than two decades of continuous democratic rule and government policies geared towards improved emergency obstetric care (EmOC) access in Nigeria, maternal mortality remains a fundamental public health challenge. Although many studies have emphasized the significance of the male role in female reproductive health-seeking behavior in the country, there is insufficient empirical evidence on the male role in accessing EmOC in Nigeria’s Niger Delta region, the bastion of the nation’s petroleum industry. This study explored women’s perspectives, beliefs, and experiences concerning the role of their husbands on reproductive health by collecting quantitative and qualitative data in an economically disadvantaged community of Bayelsa State. A semi-structured questionnaire was administered to 616 women aged 15-49 years. Focus Group Discussions (16) were conducted among purposively selected male and female participants. Men play positive roles toward accessing EmOC by women in rural Bayelsa. At least eight out of ten women reported that their husbands were present during pregnancy or birth complications; five out of ten claimed they followed them to hospitals or clinics for treatment. Men also provided the finance for the specialized care during emergencies. This study provides empirical evidence of a positive male role in accessing EmOC in the study area. More deliberate promotion of male involvement in the reproductive health of their wives will contribute significantly to the reduction of maternal mortality in a patriarchal society such as Bayelsa.

scholarly journals 2015: Year of Goals in Reproductive Health

2012 ◽  
Vol 4 (1) ◽  
pp. 1-4
Author(s):  
Laxmi Shrikhande ◽  
Sangeeta Tajpuriya
Keyword(s):  
Reproductive Health ◽  
Maternal Mortality ◽  
Health System ◽  
Health Care Services ◽  
Good Governance ◽  
Maternal Mortality Ratio ◽  
Health Sector ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Reproductive Health Services

ABSTRACT The International Conference on Population and Development (ICPD) and Millennium Development Goals agenda of reproductive health were declared as the most comprehensive one, which had actually broadened the spectrum of reproductive health and drove the states to embark upon initiatives to improve reproductive health status of their populations. Maternal health is one of the main global health challenges and reduction of the maternal mortality ratio, from the present 0.6 mio per year, by three-quarters by 2015, is the target for the fifth Millennium Development Goal (MDG 5). However, this goal is the one toward which the least progress has been made. There is not a simple and straight-forward intervention, which by itself will bring maternal mortality significantly down; and it is commonly agreed on that the high maternal mortality can only be addressed, if the health system is strengthened. There is a common consensus about the importance of skilled attendance at delivery to address the high, maternal mortality. This consensus is also reflected in the MDG 5, where the proportion of births attended by skilled health personnel is considered a key indicator. There are, however, certainly some common grounds which have been experimented by various countries and we can learn lessons from those best practices. There is a need of increasing resource allocation, strengthening primary health care services and emergency obstetric care and motivating the human resource employed in health sector by good governance. These endeavors should lead to formulate evidence-based national policies, reproductive health services which are affordable, accessible and culturally acceptable and finally a responsive health system. How to cite this article Shrikhande L, Tajpuriya S. 2015: Year of Goals in Reproductive Health. J South Asian Feder Obst Gynae 2012;4(1):1-4.

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 The effectiveness of training in emergency obstetric care: a systematic literature review

2019 ◽  
Vol 34 (4) ◽  
pp. 257-270 ◽  
Author(s):  
Charles A Ameh ◽  
Mselenge Mdegela ◽  
Sarah White ◽  
Nynke van den Broek
Keyword(s):  
Clinical Practice ◽  
Maternal Mortality ◽  
Health Outcomes ◽  
Emergency Obstetric Care ◽  
Case Fatality ◽  
Obstetric Care ◽  
Team Work ◽  
Knowledge And Skills ◽  
Effectiveness Of Training ◽  
Four Levels

Abstract Providing quality emergency obstetric care (EmOC) reduces the risk of maternal and newborn mortality and morbidity. There is evidence that over 50% of maternal health programmes that result in improving access to EmOC and reduce maternal mortality have an EmOC training component. The objective was to review the evidence for the effectiveness of training in EmOC. Eleven databases and websites were searched for publications describing EmOC training evaluations between 1997 and 2017. Effectiveness was assessed at four levels: (1) participant reaction, (2) knowledge and skills, (3) change in behaviour and clinical practice and (4) availability of EmOC and health outcomes. Weighted means for change in knowledge and skills obtained, narrative synthesis of results for other levels. One hundred and one studies including before–after studies (n = 44) and randomized controlled trials (RCTs) (n = 15). Level 1 and/or 2 was assessed in 68 studies; Level 3 in 51, Level 4 in 21 studies. Only three studies assessed effectiveness at all four levels. Weighted mean scores pre-training, and change after training were 67.0% and 10.6% for knowledge (7750 participants) and 53.1% and 29.8% for skills (6054 participants; 13 studies). There is strong evidence for improved clinical practice (adherence to protocols, resuscitation technique, communication and team work) and improved neonatal outcomes (reduced trauma after shoulder dystocia, reduced number of babies with hypothermia and hypoxia). Evidence for a reduction in the number of cases of post-partum haemorrhage, case fatality rates, stillbirths and institutional maternal mortality is less strong. Short competency-based training in EmOC results in significant improvements in healthcare provider knowledge/skills and change in clinical practice. There is emerging evidence that this results in improved health outcomes.

scholarly journals Maternal mortality and its relationship to emergency obstetric care (EmOC) in a tertiary care hospital in South India

2015 ◽  
Vol 8 (2) ◽  
pp. 86-91 ◽  
Author(s):  
Papa Dasari
Keyword(s):  
Maternal Mortality ◽  
Cause Of Death ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Emergency Admissions ◽  
Mortality Ratio

Objective: To determine the trends in maternal mortality ratio over 5 years at JIPMER Hospital and to find out the proportion of maternal deaths in relation to emergency admissions. Methods: A retrospective analysis of maternal deaths from 2008 to 2012 with respect to type of admission, referral and ICU care and cause of death according to WHO classification of maternal deaths. Results: Of the 104 maternal deaths 90% were emergency admissions and 59% of them were referrals. Thirty two percent of them died within 24 hours of admission. Forty four percent could be admitted to ICU and few patients could not get ICU bed. The trend in cause of death was increasing proportion of indirect causes from 2008 to 2012. Conclusion: The trend in MMR was increasing proportion of indirect deaths. Ninety percent of maternal deaths were emergency admissions with complications requiring ICU care. Hence comprehensive EmOC facilities should incorporate Obstetric ICU care.

scholarly journals Post-Partum Hemorrhage is Still Killing Mothers in Bangladesh: An Observation from the 2016 Bangladesh Maternal Mortality Survey (BMMS)

2020 ◽  
Author(s):  
Aminur Rahman ◽  
Anne Austin ◽  
Tahmina Begum ◽  
Iqbal Anwar
Keyword(s):  
Maternal Mortality ◽  
Universal Access ◽  
Post Partum ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Active Management ◽  
Director General ◽  
Public And Private ◽  
Third Stage ◽  
Mortality Survey

Abstract The main cause of maternal death in Bangladesh is postpartum hemorrhage (PPH). PPH accounts for 31%of maternal deaths. Proven interventions to prevent maternal mortality are active management of third stage of labour (AMTSL) and the availability of comprehensive emergency obstetric care (CEmOC). Both of these interventions mandate the administration of oxytocin. In Bangladesh there are nonfunctioning institutionalized guidelines from the Director General of Health Services on the storage of oxytocin, which may impact the potency of oxytocin used during labour. To reduce preventable PPH morbidity and mortality, Bangladesh needs to evaluate the potency of current stores of oxytocin used in both in public and private facilities, develop and enforce protocols to ensure the potency of oxytocin, and promote universal access to quality AMSTL and CEmOC services.

scholarly journals Perceptions of health workers on the referral of women with obstetric complications: a qualitative study in rural Sierra Leone

2020 ◽  
Author(s):  
R. Proos ◽  
H. Mathéron ◽  
J. Vas Nunes ◽  
A. Falama ◽  
P. Serry-Kamal ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Maternal Mortality ◽  
Sierra Leone ◽  
Health Care Workers ◽  
Health Workers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Obstetric Complications ◽  
Care Workers

Abstract BackgroundSierra Leone has one of the highest maternal mortality ratios in the world. Timely and well-coordinated referrals are necessary to reduce delays in providing adequate care for women with obstetric complications. This study describes the perspectives of health workers in rural facilities in Sierra Leone concerning the referral of women with obstetric complications.MethodsWe conducted semi-structured group interviews with health care workers in nine peripheral health units in rural Sierra Leone regarding the referral of women with obstetric complications. Themes discussed were based on an interview guide. The data was analysed by systematic text condensation.ResultsPerspectives were grouped according to the following themes identified: 1) communication between health care workers; 2) underlying influences on decision-making; 3) women’s compliance to referral; 4) logistic constraints.ConclusionSeveral factors in rural Sierra Leone are perceived to complicate timely and adequate referral of women in need of emergency obstetric care. Notable among these factors are fear among women for being referred and fear among health care workers for having maternal deaths or severe obstetric complications at their own facilities. Furthermore, the decision-making of health care workers concerning referral is negatively influenced by an atmosphere of hierarchy between health care workers. Such factors must be considered in efforts to reduce maternal mortality.

scholarly journals Maternal Mortality in a District Hospital of Bangladesh An In-Depth Search of the Underlying Causes

1970 ◽  
Vol 20 (2) ◽  
pp. 99-106
Author(s):  
Fatema Ashraf ◽  
SM Mustanzid ◽  
Marina Khanom
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Maternal Mortality ◽  
Maternal Death ◽  
Care Delivery ◽  
Emergency Obstetric Care ◽  
Case Fatality ◽  
Care Facility ◽  
Obstetric Care ◽  
Health Priorities

Maternal death is a tragedy - a social injustice to individual women, to a family and to their community. To reduce maternal mortality is at the top of the national health priorities. Emergency obstetric care service is thought to be the basis of reducing maternal mortality and morbidity. This study was carried out to determine the case fatality rate and risk factors of maternal mortality in Kushtia General Hospital, a secondary health care facility, where comprehensive Emergency Obstetric Care (EmOC) service is established. A total of 3,709 cases were admitted with pregnancy or related complications during pregnancy or within 42 days of confinement, from August 1999 to July 2000. Among them 3,186 were obstetric patients and 523 were gynaecological cases. Within this 12-months period 37 mothers died. Clinical causes of deaths were: 32 (86.48%) due to eclampsia, 3 (8.1%) due to ruptured uterus with shock, 1 (2.7%) due to induced incomplete abortion with shock and 1 (2.7%) due to PPH with shock. Almost 100% of the deaths could be prevented if they had come to the hospital at an earlier part of the disease. Responsible factors for these deaths could be at personal, familial, socio-cultural or health care center level. So this study was carried out to identify the risk factors of maternal death and also the status of health care delivery system at the peripheral level of the country i.e. the EmOC delay model in this perspective has been tried to identify. doi: 10.3329/taj.v20i2.3068 TAJ 2007; 20(2): 99-106

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