Joining the dots: a plea for precise estimates of the maternal mortality ratio in sub‐Saharan Africa

Sp, Munjanja

doi:10.1111/j.1471-0528.2009.02337.x

Cited by 8 publications

(7 citation statements)

References 9 publications

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“…Essas questões não são exclusivas do Brasil; a medida acurada da mortalidade materna permanece um desafio para outros países em desenvolvimento 62,63 .…”

Section: Discussionunclassified

Mortalidade materna no Brasil: o que mostra a produção científica nos últimos 30 anos?

et al. 2011

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O objetivo deste trabalho foi descrever o perfil epidemiológico e a tendência da mortalidade materna no Brasil, por meio de revisão de estudos sobre o tema. Foi realizada busca eletrônica de artigos científicos publicados entre 1980 e 2010, nas bases de dados LILACS e MEDLINE. Identificaram-se inicialmente 486 artigos. Após aplicação dos critérios de inclusão e exclusão restaram 50 artigos. A comparação dos dados mostrou queda da RMM de forma diferenciada nas regiões brasileiras. Os estudos sobre determinação do óbito materno apontaram desigualdades sociais relacionadas à cor da pele e escolaridade. O preenchimento incompleto da declaração de óbito e a subnotificação ainda persistem. Prevaleceram as causas obstétricas diretas, com predomínio das doenças hipertensivas. Quando analisada, a evitabilidade apontou falhas na assistência pré-natal e ao parto. Apesar de sua relevância, são poucos os artigos sobre mortalidade materna no Brasil. A RMM, embora em declínio, permanece em níveis elevados. Melhorias na qualidade da assistência pré-natal e ao parto são necessárias.

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“…Essas questões não são exclusivas do Brasil; a medida acurada da mortalidade materna permanece um desafio para outros países em desenvolvimento 62,63 .…”

Section: Discussionunclassified

Mortalidade materna no Brasil: o que mostra a produção científica nos últimos 30 anos?

et al. 2011

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“…Even though the study of maternal mortality is increasingly difficult, the maternal mortality ratio (MMR) is the key measure of the standard of obstetric care [23][24][25]. Compared to the MMR, a review of MNM cases is quite important for assessing what goes wrong in pregnancyrelated care when an MNM happens in a specific environment [26,27].…”

Section: Introductionmentioning

confidence: 99%

Determinants of maternal near miss among women admitted to maternity wards of tertiary hospitals in Southern Ethiopia, 2020: A hospital-based case-control study

Habte¹,

Wondimu

2021

PLoS ONE

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Background A maternal near-miss (MNM) refers to when a gravely ill woman survives a complication as a result of the standard of care she receives or by chance during gestation, childbirth, or within 42 days of the termination of pregnancy. Rescuers of near-miss events share several features with mothers who have died and identifying MNM determinants will aid in improving the capacity of the health system to reduce severe maternal morbidity and mortality. Ethiopia is one of the countries in sub-Saharan Africa with high maternal mortality and morbidity, but there is little evidence on determinants of a MNM based on a WHO criteria. Hence, this study aimed at identifying determinants of MNM among women admitted to tertiary hospitals in southern Ethiopia, 2020. Methods A facilities-based unmatched case-control study was conducted in five selected tertiary hospitals found in central southern Ethiopia from February 1 to June 1, 2020. A total of 322 (81 cases and 241 controls) study participants were included in the study. At the time of their discharge, cases were recruited consecutively, while controls were selected using a systematic sampling method. The cases were women admitted to hospitals during pregnancy, childbirth, or 42 days following termination of pregnancy who met at least one of the WHO near-miss criteria. Whereas the controls comprised of women who were admitted during pregnancy, childbirth, or 42 days following termination of pregnancy and discharged without severe obstetric complications. Data collection was conducted using the interviewer-administered structured questionnaire and data abstraction tool. The data was coded and entered into Epi-Data version 3.1 and exported to SPSS version 23 for analysis. Multivariable logistic regression analysis was conducted and determinants of MNM were established at p-value<0.05. Results Severe postpartum hemorrhage (50.6%) and sepsis (23.4%) were the most common reasons for admission of cases. Lack of ANC [AOR = 3.25; 95%CI: 2.21,7.69], prior history of Cesarean section [AOR = 3.53; 95%CI:1.79,6.98], delaying more than 60 minute to access final place of care [AOR = 3.21; 95%CI:1.61,6.39], poor practice of Birth preparedness and complication readiness (BPCR) [AOR = 3.31; 95%CI:1.50,7.29], and history of preexisting medical disorders [AOR = 2.79; 95%CI:1.45,5.37] were identified as significantly determinants of maternal near miss. Conclusion and recommendation Stakeholders need to enhance their efforts for improving access to roads and transportations. Besides, women who have a prior history of Caesarean section, chronic medical conditions, and no ANC need special attention from their families and health care providers to proactively mitigate the occurrence of serious obstetric complications. More attention has to be paid to birth preparedness and complication readiness activities.

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“…The primary indicator of maternal health care quality is the maternal mortality ratio (MMR). 4 However, monitoring only maternal death at health facility does not provide a complete source of information on which to base steps to prevent further deaths. 5 Thus, women who survive severe complications during pregnancy, childbirth, and the postpartum period could serve as surrogates to help us gain a better understanding of the set of conditions and preventable factors that contribute to a maternal death.…”

Section: Introductionmentioning

confidence: 99%

<p>Incidence-Proportion of Maternal Near-Misses and Associated Factors in Southwest Ethiopia: A Prospective Cross-Sectional Study</p>

Yemane

Tiruneh

2020

IJWH

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Background: Pregnancy-related morbidity and mortality continue to have a serious impact on the lives of women all over the world. Women in sub-Saharan Africa accounted for nearly two-thirds of global maternal deaths. The World Health Organization recommends monitoring maternal near-miss provides better information regarding the quality of maternal health care, on which to base action to prevent further death. Accordingly, this study sought to assess the incidence-proportion of maternal near-miss and its risk factors. We have also seen the near-miss-to-mortality ratio and overall maternal mortality index. Methods: An institution-based prospective cross-sectional study was carried out from February 6, 2017 to March 6, 2017, using the WHO criteria for maternal near-misses at the three randomly selected public hospitals. About 845 participants were enrolled in the study with systematic random sampling techniques. WHO multi-country survey on maternal and neonatal health tool was used. Descriptive statistics and bivariate logistic regression analysis were done. Variables with p-value <0.2 in the bivariate analysis were transferred to multivariable analysis, and during multivariate logistic regression analysis, variables with P-value <0.05 were considered as statistically significant with 95% CI. Results: There were 5530 live births, 210 maternal near-misses, 17 maternal deaths, and 364 maternal near-miss events. The overall proportion of maternal near-miss is 24.85%. Besides, the ratio of maternal near-misses to maternal mortality was 12.35:1, and the overall mortality index was 7.48%. Parity, residence, a distance of maternal home from the hospital, ANC follow-up, duration of labor, and administration-related problems were found to have statistically significant associations. Conclusion: The incidence-proportion of maternal near-misses is relatively high when compared against the national target and to other regional studies. Besides, with all its limitations, the outcome indicators and outcome measures in this study seem to suggest optimum care is being given to mothers who suffered from life-threatening complications.

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Joining the dots: a plea for precise estimates of the maternal mortality ratio in sub‐Saharan Africa

Cited by 8 publications

References 9 publications

Mortalidade materna no Brasil: o que mostra a produção científica nos últimos 30 anos?

Mortalidade materna no Brasil: o que mostra a produção científica nos últimos 30 anos?

Determinants of maternal near miss among women admitted to maternity wards of tertiary hospitals in Southern Ethiopia, 2020: A hospital-based case-control study

<p>Incidence-Proportion of Maternal Near-Misses and Associated Factors in Southwest Ethiopia: A Prospective Cross-Sectional Study</p>

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