Diversity and divergence: the dynamic burden of poor maternal health

Graham, Wendy; Woodd, Susannah; Byass, Peter; Filippi, Véronique; Gon, Giorgia; Virgo, Sandra; Chou, Doris; Hounton, Sennen; Lozano, Rafael; Pattinson, Robert Clive; Singh, Susheela

doi:10.1016/s0140-6736(16)31533-1

Cited by 221 publications

(213 citation statements)

References 80 publications

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“…As noted earlier, reducing inequalities is acknowledged as a sub-target in both the EPMM and ENAP strategies. Significant gaps between rich and poor groups in service uptake and in mortality outcomes have been highlighted among all recent Lancet series -for newborns, stillbirths and most recently for maternal health (4,8,11).…”

Section: Where In the World To Focus Attention In The Sdg Period?mentioning

confidence: 99%

“…The term "fragile state" specifically designates countries according to a broader set of factors, with the Fragile States Index (FSI) ranking countries according to their stability based on twelve indicators including deterioration of public services, security threats, and sharp economic decline (12). Given the gendered nature of many risks in these settings, such as sexual violence and a lack of routine and emergency services, these populations of women and newborns are indeed vulnerable (11,13,14). A significant proportion of this vulnerability is found in fragile states in subSaharan Africa.…”

Section: Where In the World To Focus Attention In The Sdg Period?mentioning

confidence: 99%

“…However, the proportion of indirect causes of death, both communicable and non-communicable, is increasing in most countries, reflecting the epidemiological transition described further below. This impacts upon the pattern of timing of deaths, with increasing fraction occurring during the antepartum and especially postpartum period, including late maternal deaths (11). Inevitably the indirect proportion will continue to increase in the future in response to this advancing transition and as direct causes are addressed through quality emergency obstetric care and skilled care at birth (17).…”

Section: When To Focus Attention Along the Continuum Of Care?mentioning

confidence: 99%

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Evidence to inform the future for maternal and newborn health

Lawn

Blencowe

Kinney³

et al. 2016

Best Practice & Research Clinical Obstetrics & Gynaecol

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Despite the impressive progress gains for maternal and child health during the Millennium Development Goals era, over 5.6 million women and babies died in 2015 due to complications during pregnancy, birth and in the first month of life. In order to achieve the new mortality targets set out in the Sustainable Development Goals, there needs to be intentional efforts to maintain and accelerate efforts to end preventable maternal and newborn deaths and stillbirths. This paper outlines what progress is required to meet these new 2030 targets based on patters of progress in the recent past; where the burden is the greatest; when to focus attention along the continuum of care; and what causes of death require concerted efforts.Priority actions include intentional and intensified political attention and investment in maternalnewborn health with particular focus on improving quality and experience of care around the time of birth with implementation at scale of integrated maternal-newborn health interventions across the continuum of care with commensurate investment targeted at the most vulnerable populations. Looking forward, improved data for decision making and accountability will required.The health and survival of babies and their mothers are inextricably linked, and calls for coordinated efforts and innovation before and during pregnancy, in childbirth, and postnatally, in order to end preventable maternal, neonatal deaths and stillbirths.3

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Section: Where In the World To Focus Attention In The Sdg Period?mentioning

confidence: 99%

Section: Where In the World To Focus Attention In The Sdg Period?mentioning

confidence: 99%

Section: When To Focus Attention Along the Continuum Of Care?mentioning

confidence: 99%

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Evidence to inform the future for maternal and newborn health

Lawn

Blencowe

Kinney³

et al. 2016

Best Practice & Research Clinical Obstetrics & Gynaecol

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“…To reduce substantially maternal mortality, it is necessary to integrate the emergency care with the improvement in the quality of maternal healthcare since the pregnancy (Souza et al, 2013). The increase of diversity in the causes of maternal morbidity and mortality is an important challenge to the policies and programs that aim at meeting varied needs with different types of care in different contexts (Graham, Woodd, Byass, Filippi, Gon, Virgo, & Singh et al, 2016). Accessing basic screenings in prenatal monitoring as recommended by the Brazilian Ministry of Health is important for the quality of healthcare of the mother-child binomial.…”

Section: Introductionmentioning

confidence: 99%

Barriers to access prenatal screening: integrative review

Carvalho

Göttems

Monteiro

et al. 2018

mill

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RESUMOIntrodução: O acompanhamento pré-natal é fundamental para a redução das taxas de morbimortalidade materna e neonatal. No entanto, barreiras organizacionais podem dificultar o acesso às ações e serviços cursando com a fragmentação do cuidado e da qualidade da assistência. Objetivos: Analisar na produção científica brasileira, as barreiras de acesso a realização de exames no acompanhamento pré-natal. Método: Revisão integrativa de publicações nas bases científicas da Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Base de dados de Enfermagem (BDENF) e Medical Literature Analysis and Retrieval System Online (MEDLINE), publicados nos idiomas português, inglês e espanhol, no período de 2005 a 2015. Resultados: O processo de busca resultou em 708 artigos dos quais 15 cumpriram os critérios de inclusão. Os estudos foram sistematizados e originaram quatro categorias para análise: (1) Lentidão no processo de agendamento, coleta e liberação de resultados; (2) Quotas insuficientes dos exames destinados a atenção primária; (3) Falta de recursos das gestantes; e (4) Adequação dos exames relacionada ao início precoce do pré-natal. Conclusões: As barreiras de acesso aos exames no acompanhamento pré-natal estão relacionadas principalmente aos recursos escassos na saúde destinados à atenção primária; à lentidão no processo de agendamento e realização; e, a falta de recursos da gestante para arcar com os custos de exames não realizados pelo sistema público. As publicações também evidenciaram os aspectos positivos para as gestantes que iniciaram pré-natal precoce. Palavras-chaves:Cuidado pré-natal; Gestantes; Acesso aos serviços de saúde. Conclusions:The access barriers to screenings in the prenatal monitoring are mainly related to the scant health resources devoted to primary care; sluggishness in the process of scheduling and running of tests; and to the lack of resources of the pregnant woman, who cannot afford the costs of examinations not covered by the public health system. The publications also highlighted the positive aspects for the pregnant women who had an early onset of prenatal care.

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“…Further excessive medicalization, unregulated ultrasounds, labour inductions, caesarean sections (CS) with their spillover effects on perinatal outcome also seem to offset the gains from improved maternal/neonatal care. Each year, about 210 million women become pregnant and 140 million newborn babies are delivered -the sheer scale of maternal health alone makes maternal wellbeing and survival vital concerns [1].…”

Section: Introductionmentioning

confidence: 99%