A comparison of approaches to measuring maternal mortality in Bangladesh, Mozambique, and Bolivia

Background Many low- and middle-income countries cannot measure maternal mortality to monitor progress against global and country-specific targets. While the ultimate goal for these countries is to have complete civil registrations systems, other interim strategies are needed to provide timely estimates of maternal mortality. Objective The objective is to inform on potential options for measuring maternal mortality. Methods This paper uses a case study approach to compare methodologies and estimates of pregnancy-related mortality ratio (PRMR)/maternal mortality ratio (MMR) obtained from four different data sources from similar time periods in Bangladesh, Mozambique, and Bolivia—national population census; post-census mortality survey; household sample survey; and sample vital registration system (SVRS). Results For Bangladesh, PRMR from the 2011 census falls closely in line with the 2010 household survey and SVRS estimates, while SVRS’ MMR estimates are closer to the PRMR estimates obtained from the household survey. Mozambique's PRMR from household survey method is comparable and shows an upward trend between 1994 and 2011, whereas the post-census mortality survey estimated a higher MMR for 2007. Bolivia's DHS and post-census mortality survey also estimated comparable MMR during 1998–2003. Conclusions Overall all these data sources presented in this paper have provided valuable information on maternal mortality in Bangladesh, Mozambique, and Bolivia. It also outlines recommendations to estimate maternal mortality based on the advantages and disadvantages of several approaches. Contribution Recommendations in this paper can help health administrators and policy planners in prioritizing investment for collecting reliable and contemporaneous estimates of maternal mortality while progressing toward a complete civil registration system.

Delineation of public health risk factor associate with the mortality ratio in covid-19 pandemic situation during legislative assembly elections from Indian states

The coronavirus is an accurate disease and this virus-related pandemic is hammering human health and increased the public health emergency till now. The main objective of this study is to find out the death, mortality ratio, new cases, and recoveries case identification and correlation analysis between them using regression technique on legislative assembly elections from India. This study encompassed the present disorder of India throughout the elections time in India from 27th March 2021 to 29th April 2020. Statistical analysis was developed by the covid-19 database for monitoring and analyzing the health statutes during elections. Mortality ratio, the relation between active and death cases, active cases and recover cases in India are calculating corona affected data. The results show that death cases were high in the second wave of coronavirus in India. The correlation between daily death and new cases was strong positive (R2= 0.9306). The relationship between recoveries and death was stronger positive (R2=0.9832). The daily death and active cases collation indicated that strong positive (R2= 0.9703). The COVID-19 is dangerous to people's health. The virus is more life-threatening and if people will not follow the WHO guidelines, and it strength demonstration additional havoc very shortly.

Demand Side Financing and Healthcare Seeking of Pregnant Women

Demand-side financing (DSF) scheme is popularly known as the maternal health voucher program, which is launched in many developing countries of the world including Bangladesh as an intervention of developing overall health status. Maternal mortality ratio is a strong indicator of health profile of any country and pregnant women are prone to fall vulnerable situation. This review was aimed to find gap/missing of existing literature in order to make foundation of new research on healthcare seeking of pregnant women along with financing coverage. After repeated critical review of number original articles, some gaps have been found. Almost every article they focused on outcome and mildly highlighted input variables but did not consider all possible variables and missed to show interlink between those variables.

WIDOWER’S AGE AND NUMBER OF CHILDREN AFFECT PARENTING STYLE AND REMARRIAGE DECISION

Highlight:1. The widow will outsource childcare to other people, such as the widow's mother, stepmother, aunt, or other relatives who believe they know more about childcare after the wife's death.3. There was a significant relationship between widower’s age and the number of children affecting parenting style and remarriage decision.Abstract:Background: The high maternal mortality ratio automatically represents the highest number of widowers in Indonesia. The change of status from a husband to a widower does not rule out the possibility of being able to change his role and function in the family. Objective: To describe that the widower’s age and the number of children have an impact on the parenting style and the desire to remarry. Materials and Methods: This study was an observational study with a cross-sectional design. Husbands who had been left by their wives for two years or more owing to maternal death and had one or more children before the wife's maternal death were the subjects of this study. Widower’s age, as well as kid’s parenting patterns before the death of the mother were recorded. This study was likewise subjected to an ethics review and relied on informed consent. Results: Widowers who had one child before their wife's death and decided to remarry accounted for 7 subjects (87.5%), while those who did not remarry accounted for 5 (31.3%). On the association between a widower’s age and child-rearing practices, there were two respondents (40%) who chose to entrust their children’s care to someone else or not to be cared by themselves. Conclusion: There was a significant relationship between widower’s age and the number of children and the parenting style and remarriage decision. Single parents who decided to remarry were single parents at a relatively younger age.

Maternal mortality in the city of Berlin: consequences for perinatal healthcare

Objectives The fifth of the United Nations’ Millennium Development Goals proposed for 2000–2015 was to improve maternal health, which has only partially been achieved. Worldwide, the maternal mortality ratio is currently estimated at 216/100.000 livebirths, compared to 380/100,000 in 1990. As yet, there has been no published comprehensive analysis of maternal mortality data as it pertains to Berlin and by extension Germany. Aim of the study was to evaluate and analyze the maternal mortality rate of Berlin as a result of shortcomings in healthcare provision and identify possible solutions. Methods The Institute for Quality and Transparency in the Healthcare Sector sourced external quality control from the Qualitätsbüro Berlin to provide maternal mortality data from Berlin hospitals from 2007 to 2020. Results Nineteen maternal deaths were registered between 2007 and 2020 in total. Case analysis shows that two main events occur: thrombosis and hemorrhage at 31.6%, respectively, followed by hypertensive disorder (15.8%), and sepsis (15.8%). After detailed analysis of each case report, we determined 8/19 (42.1%) maternal deaths as being potentially preventable given slightly altered circumstances. Consequences The system of registration of perinatal data in Germany does not allow for a comprehensive recording of maternal death and requires alteration to provide a more accurate picture of the phenomenon of maternal mortality; presumably, there exist twice as many unreported cases. Conclusions Symptoms, risks, and primary prevention tactics of thromboembolism during pregnancy and birth should be imparted to every licensed professional in individual hospital settings, along with evidence-based simulation training for the event of obstetric or prepartum hemorrhage.

Analysis of novel antineoplastic drugs treatment impact on the federal project «cancer control» goals achievement

The Federal project “Cancer Control” was launched in 2019. Its main objective is to reduce mortality from malignant neoplasms in Russia. The main goal of this research is to develop a methodology for assessment of innovative drugs treatment impact on reducing mortality from neoplasms (including malignant) and testing it in the case of some novel drugs. Materials and methods. Firstly, we assessed the number of patients, who annually can start a novel drug treatment. Afterwards we estimated the number of deaths, which could be avoided due to the efficacy differences between innovative drugs compared to the standard of care in terms of overall survival. Obtained results were than correlated to the reduction in malignant mortality ratio needed to achieve annually (comparing to the basis 2020). For the approbation of the model, we chose durvalumab, osimertinib and olaparib, which are indicated for lung and ovarian cancer treatment. Results. Annually 6 746 patients can start the treatment: 2 391 with durvalumab, 2 334 with osimertinib, 2 021 with olaparib. In the 2021-2023 frame durvalumab treatment can help to avoid 779 deaths, osimertinib treatment can help to avoid 723 deaths, olaparib treatment can help to avoid 679 deaths (totally 10,8% of reduction in deaths needed to achieve 2021-2023 goals). Conclusion. Novel antineoplastic drugs treatment leads to a quantifiable reduction in mortality from malignant neoplasms in Russia.

A retrospective analysis of maternal mortality in an urban tertiary care hospital

Background: The aims of the study were to generate information regarding causes and complications leading to maternal deaths in an urban tertiary care centre and to find if any of the causes are preventable.Methods: The medical records of all maternal deaths occurring over a period of 4 years between January 2015 and December 2018 were reviewed.Results: Maternal mortality ratio ranged between 127 and 48 per 1, 00,000 births in the study. The causes of deaths were haemorrhage (29.47%), pregnancy-induced hypertension (PIH) (28.42%), anaemia (12.63%), sepsis (9.47%), thromboembolism (6.31%), hepatic causes (5.26%), blood reactions (3.15%), heart diseases (2.10%), central nervous system (CNS) related (1.05%) and others (2.10%). Maximum deaths occurred in women between 21-30 years of age. Mortality was highest in post-natal mothers (70.52%).Conclusions: Overall maternal mortality due to direct obstetric causes was (73.68%), indirect obstetric causes (22.10%) and unrelated causes (4.2%).

Determinants for Postpartum Care of Women in Rakhine State, Myanmar: A Descriptive Cross- sectional Study

Background – The maternal mortality ratio of Rakhine State is cited as being the highest level among the states of Myanmar. In contrast, the usage of healthcare providers for the delivery process is at the lowest rate in the Union. Therefore, this study sought to discover the factors influencing women from Rakhine State in receiving postpartum care from healthcare providers.Methodology – All in all, 278 women from the 15- to 49-year-old age group collected from the Myanmar Demographic Health Survey (2015-2016) were used for this study. Binary logistic regression was likewise employed. Results –Among the 104 cases receiving postpartum care, only 42 cases were home deliveries. Maternal health knowledge status, the role of healthcare providers, and places of delivery, rather than socioeconomic status and social structure, were the most essential factors in promoting postpartum care status. The occupation status of women also influenced their postpartum care receiving status.Conclusion – By strengthening the health care system setting and promoting the job efficacy of women, the postdelivery care status of Rakhine state can be increased and the maternal death after child birth can be reduced to reach the SDGs.

The Current Status in Obstetrics in North Korea and Strategies for Establishing a Better Healthcare System

The women's healthcare in North Korea is in poor condition. The present study explored the current state of women's healthcare, especially in the field of obstetrics, in the region with a number of considerations in regards to establishing a better healthcare system. Peer-reviewed journal articles and reports from intergovernmental organizations were reviewed. Data show that many healthcare facilities suffer from shortages of basic amenities. The maternal mortality ratio was 82 deaths per 100,000 live births. The leading cause of maternal death was postpartum hemorrhage. It was also found that many hospitals were unable to provide adequate obstetrical emergency care such as anticonvulsants, antibiotics, and blood products. A long-term roadmap that is sustainable with clear principles and that is not disturbed by political tensions should be established.