A Strategy for Reducing Maternal Mortality in Rural Kenya

Masaba, Brian Barasa; Mmusi-Phetoe, Rose

doi:10.2147/ijwh.s396257

Cited by 4 publications

(5 citation statements)

References 51 publications

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“…Initiatives to improve the quality of maternal healthcare services, enhance access to education, and alleviate poverty may have played a key role [ 88 , 89 , 90 , 91 ]. However, the MMR remains relatively high, suggesting that challenges such as health system weaknesses, the low socioeconomic status of women, and limited access to healthcare services are still prevalent [ 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 ].…”

Section: Discussionmentioning

confidence: 99%

Trends, Projections, and Regional Disparities of Maternal Mortality in Africa (1990–2030): An ARIMA Forecasting Approach

Onambele,

Guillen-Aguinaga,

Guillen-Aguinaga

et al. 2023

Epidemiologia

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With the United Nations Sustainable Development Goals (SDG) (2015–2030) focused on the reduction in maternal mortality, monitoring and forecasting maternal mortality rates (MMRs) in regions like Africa is crucial for health strategy planning by policymakers, international organizations, and NGOs. We collected maternal mortality rates per 100,000 births from the World Bank database between 1990 and 2015. Joinpoint regression was applied to assess trends, and the autoregressive integrated moving average (ARIMA) model was used on 1990–2015 data to forecast the MMRs for the next 15 years. We also used the Holt method and the machine-learning Prophet Forecasting Model. The study found a decline in MMRs in Africa with an average annual percentage change (APC) of −2.6% (95% CI −2.7; −2.5). North Africa reported the lowest MMR, while East Africa experienced the sharpest decline. The region-specific ARIMA models predict that the maternal mortality rate (MMR) in 2030 will vary across regions, ranging from 161 deaths per 100,000 births in North Africa to 302 deaths per 100,000 births in Central Africa, averaging 182 per 100,000 births for the continent. Despite the observed decreasing trend in maternal mortality rate (MMR), the MMR in Africa remains relatively high. The results indicate that MMR in Africa will continue to decrease by 2030. However, no region of Africa will likely reach the SDG target.

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Section: Discussionmentioning

confidence: 99%

Trends, Projections, and Regional Disparities of Maternal Mortality in Africa (1990–2030): An ARIMA Forecasting Approach

Onambele,

Guillen-Aguinaga,

Guillen-Aguinaga

et al. 2023

Epidemiologia

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“…Awareness on birth preparedness and complication readiness (BP & CR) will be measured by ve (5) items on a binary scale. One point will be awarded for the correct answer and zero for the wrong answer.…”

Section: Variables and Variables Measurementmentioning

confidence: 99%

“…A total score will be ve (5), those who will be able to mention/identify at least three (3) out of ve (5) BP & CR components will be regarded as being aware and have adequate knowledge on BP & CR (30).…”

Section: Variables and Variables Measurementmentioning

confidence: 99%

“…One point will be awarded for the accomplished practice and zero for non-accomplished practice. A total score will be ve (5), whereby those who will have accomplished at least three (3) out of ve (5) birth preparedness and complication readiness factors will be regarded as having good practice of birth preparedness and complication readiness (30).…”

Section: Variables and Variables Measurementmentioning

confidence: 99%

“…Maternal mortality commonly occurs during intrapartum and the rst day post-partum (2) and Obstetric danger signs account for more than 75% of all obstetric complications leading to maternal deaths (3,4). However, there is still low knowledge of obstetric danger signs, birth preparedness, and complication readiness and their practice among pregnant women, which plays a signi cant role in the slow pace of maternal mortality reduction (5).…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of Community Engagement Using M-Mama Champions in Improving Literacy of Obstetric Danger Signs, Birth Preparedness and Complication Readiness Among Pregnant Women in Bahi, Dodoma. A Community-Based, Cluster Randomized Controlled Trial

Sanga,

Kibusi,

Kengia

2024

Preprint

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Background: Maternal mortality remains a global public health issue, Sustainable Development Goal 3 targets to reduce it to less than 70 for every 100,000 live births by 2030. Maternal mortality whose peak is during intrapartum and the first day post-partum, 75% of it is accounted for by obstetric danger signs complications. Tanzania’s maternal mortality ratio stands at 104 for every 100,000 live births higher than the SDG target. Innovations that include M-MAMA Champions as facilitators in women groups are necessary to improve the literacy level of obstetric danger signs, birth preparedness, and complication readiness among pregnant women and enhance obstetric emergency response and service utilization, for essential interventions in healthcare facilities alone haven’t been able to reduce maternal mortality due to poor services utilization. Methods: In a community-based, parallel-group cluster randomized controlled trial (cRCT) design, a total of 120 first and second-trimester pregnant women will be randomized at a ratio of 1:1 to the intervention and control groups. The sensitizing pregnant women on Obstetric danger signs, birth preparedness, and complication readiness by the empowered M-MAMA Champions to the intervention arm will be done for a period of one month, each two-hour session will be delivered in an interval of two weeks, using participatory learning and action model. The effect of the intervention will be determined using repeated ANOVA analysis, of which the effect of M-MAMA Champions on literacy level and practice between arms will be determined. Discussion; Implementation fidelity of the intervention will be ensured through implementation observation by the researcher, research assistants, and the community health workers. Ethics approval and consent to participate; The University of Dodoma Research Ethics Committee approved this study (Ref. No. MA.84/261/02/1/115). The study will ensure the protection of the participants’ values, dignity, and integrity per the Helsinki Declaration by the World Medical Association.

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Factors associated with quality of intrapartum care in Kenya: a complex samples analysis of the 2022 Kenya demographic and health survey

Nuwabaine,

Amwiine,

Sserwanja

et al. 2024

Preprint

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Background Quality of intrapartum care remains a key intervention for increasing women’s utilization of skilled birth attendants in health facilities and improving maternal and newborn health. This study aimed to investigate the factors associated with the quality of intrapartum care using the 2022 Kenya Demographic and Health Survey (KDHS). Methods Secondary data from the 2022 KDHS of 11,863 participants, who were selected by multistage stratified sampling, was used. Quality of intrapartum care was considered if a mother had a facility-based delivery, received skilled assistance during birth, and the baby immediately placed on the mother’s breast by skilled birth attendant within 1 hour after birth. We conducted multivariable logistic regression to determine the factors associated with quality of intrapartum care using SPSS (version 20). Results Of the 11,863 women who had recently given birth, about 52.6% had received quality intrapartum care. As part of the intrapartum care, 88.2% gave birth in a health facility, 90.4% obtained assistance from skilled birth attendants, and 59.8% had their babies placed on the breast by delivery assistants within 1 hour after birth. Women who had attained secondary education (aOR = 1.46, 95% CI: 1.23–1.90), were working (aOR 1.24, 95% CI: 1.00-1.53), had > = 3 living children (aOR = 1.31 ,95% CI: 1.02–1.68), took 31–60 minutes to reach the health facility (aOR = 1.49, 95% CI: 1.41–1.95), were assisted during child birth by doctors (aOR = 19.86, 95% CI: 2.89-136.43) and nurses/midwives/clinical officers (aOR = 23.09, 95% CI: 3.36-158.89) had higher odds of receiving quality intrapartum care. On the other hand, women in the richest wealth index (aOR = 0.64, 95% CI: 0.42–0.98), those who gave birth through cesarean section (AOR = 0.27, 95% CI: 0.20–0.36) and those whose current age of their child was > = 2years (AOR = 0.76, 95% CI: 0.60–0.96) were less likely to receive quality intrapartum care. Conclusions About half of the women received quality clinical intrapartum care in Kenya, with demographic characteristics seeming to be the main drivers of quality intrapartum care. There is need to empower women through increasing access to education and developing initiatives for their economic independence, as well as facilitating their increased access to skilled birth attendants to improve the quality of intrapartum care.

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A Strategy for Reducing Maternal Mortality in Rural Kenya

Cited by 4 publications

References 51 publications

Trends, Projections, and Regional Disparities of Maternal Mortality in Africa (1990–2030): An ARIMA Forecasting Approach

Trends, Projections, and Regional Disparities of Maternal Mortality in Africa (1990–2030): An ARIMA Forecasting Approach

Effectiveness of Community Engagement Using M-Mama Champions in Improving Literacy of Obstetric Danger Signs, Birth Preparedness and Complication Readiness Among Pregnant Women in Bahi, Dodoma. A Community-Based, Cluster Randomized Controlled Trial

Factors associated with quality of intrapartum care in Kenya: a complex samples analysis of the 2022 Kenya demographic and health survey

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