Improving Emergency Obstetric Care in a Context of Very High Maternal Mortality: The Nepal Safer Motherhood Project 1997–2004

Rath, Alison Dembo; Basnett, Indira; Cole, Melissa; Subedi, Hom Nath; Thomas, Deborah S.K.; Murray, Susan

doi:10.1016/s0968-8080(07)30329-7

Cited by 22 publications

(20 citation statements)

References 18 publications

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“…3,33,34 Research into costs consolidated support for demand-side financing, and the Safe Delivery Incentive Programme was launched in 2005. Since 2009, it has continued within Nepal's wider Aama Programme and was recently rebranded as Aama Surakshya Karyakram.…”

Section: Nepalmentioning

confidence: 99%

Improving access to maternity services: an overview of cash transfer and voucher schemes in South Asia

Jehan¹,

Sidney

Smith

et al. 2012

Reproductive Health Matters

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Section: Nepalmentioning

confidence: 99%

Improving access to maternity services: an overview of cash transfer and voucher schemes in South Asia

Jehan¹,

Sidney

Smith

et al. 2012

Reproductive Health Matters

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“…Most of these programmes use healthcare-worker training as the point of departure. They are often embedded in safemotherhood-type programmes [16] or sector-wide approach (SWAp) initiatives [17]. Some of the more well-known programmes are Advance in Labour and Risk Management (ALARM) [18], Making It Happen [19], Practical Obstetric Multi-Professional Training (PROMPT) [20] and ALSO (Advanced Life Support in Obstetrics) [21].…”

Section: Programmesmentioning

confidence: 99%

“…Women need to first deliver in facilities [40], and encouraging this practice may require consideration to lateral incentives [22] before facility-based scale up has a penetrating effect. Once willing to deliver in a facility, women and communities must be educated about where to deliver related to a risk assessment so that no undue burden is placed on a select group of care providers [16]. Women must then have transport to access the EmONC service, as delay in getting to a care facility impacts on the outcomes of an EmONC programme [46].…”

Section: Awareness Across the Boardmentioning

confidence: 99%

What is needed for taking emergency obstetric and neonatal programmes to scale?

Bergh

Allanson

Pattinson

2015

Best Practice & Research Clinical Obstetrics & Gynaecol

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Scaling up an emergency obstetric and neonatal care (EmONC) programme entails reaching a larger number of people in a potentially broader geographical area. Multiple strategies requiring simultaneous attention should be deployed. This paper provides a framework for understanding the implementation, scale up and sustainability of such programmes. We reviewed existing literature and drew on our experience in scaling up the Essential Steps in the Management of Obstetric Emergencies (ESMOE) programme in South Africa. We explore the non-linear change process and conditions to be met for taking an existing EmONC programme to scale. Important concepts cutting across all components of a programme are equity, quality and leadership. Conditions to be met include appropriate awareness across the board and a policy environment that leads to: commitment, healthsystems-strengthening actions, allocation of resources (human, financial, capital/material), dissemination and training, supportive supervision, and monitoring and evaluation.

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“…Low-income women, those from marginalized groups, and women in remote rural areas often lack high quality, accessible delivery care when they need it. 3–5 Deliveries occur on their own schedule and complications can be hard to predict. The low status of women in many parts of the world also increases the chance of potentially risky pregnancies (e.g.…”

mentioning

confidence: 99%

“…other rural areas of western China, Nepal, northern India, southeast Asia and Bangladesh – as well as middle- and low-income countries in other regions. 5,13,19,20 …”

mentioning

confidence: 99%

Reducing high maternal mortality rates in western China: a novel approach

Gyaltsen¹,

Gyal²,

Gipson³

et al. 2014

Reproductive Health Matters

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Among the Millennium Development Goals, maternal mortality reduction has proven especially difficult to achieve. Unlike many countries, China is on track to meeting these goals on a national level, through a programme of institutionalizing deliveries. Nonetheless, in rural, disadvantaged, and ethnically diverse areas of western China, maternal mortality rates remain high. To reduce maternal mortality in western China, we developed and implemented a three-level approach as part of a collaboration between a regional university, a non-profit organization, and local health authorities. Through formative research, we identified seven barriers to hospital delivery in a rural Tibetan county of Qinghai Province: (1) difficulty in travel to hospitals; (2) hospitals lack accommodation for accompanying families; (3) the cost of hospital delivery; (4) language and cultural barriers; (5) little confidence in western medicine; (6) discrepancy in views of childbirth; and (7) few trained community birth attendants. We implemented a three-level intervention: (a) an innovative Tibetan birth centre, (b) a community midwife programme, and (c) peer education of women. The programme appears to be reaching a broad cross-section of rural women. Multilevel, locally-tailored approaches may be essential to reduce maternal mortality in rural areas of western China and other countries with substantial regional, socioeconomic, and ethnic diversity.

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Improving Emergency Obstetric Care in a Context of Very High Maternal Mortality: The Nepal Safer Motherhood Project 1997–2004

Cited by 22 publications

References 18 publications

Improving access to maternity services: an overview of cash transfer and voucher schemes in South Asia

Improving access to maternity services: an overview of cash transfer and voucher schemes in South Asia

What is needed for taking emergency obstetric and neonatal programmes to scale?

Reducing high maternal mortality rates in western China: a novel approach

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