Malaysian Antenatal Risk Coding and the Outcome of Pregnancy

Geefhuysen, Coeli J.; Isa, Abdul Rahman; Hashim, Mohammed; Barnes, Anthony

doi:10.1111/j.1447-0756.1998.tb00046.x

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…Low effectiveness of antenatal risk assessment has also been observed in other countries and many risk factors have shown to be poor predictors of adverse outcomes ( Maine 1991; McDonagh 1996; Geefhuysen et al . 1998 ; Jahn et al .…”

Section: Discussionmentioning

confidence: 99%

Maternity care in rural Nepal: a health service analysis

Jahn

Iang²,

Shah

et al. 2000

Tropical Med Int Health

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SummaryThis study assesses the performance of maternity care and its specific service components (preventive interventions in antenatal care, antenatal screening, referral, obstetric care) in Banke District, Nepal, using a set of structure, process, and output/outcome indicators. Data sources included health service documents in 14 first level health units and two hospitals, covering 1378 pregnancies and 1323 deliveries, structured observations, antenatal exit interviews (n ϭ 136) and interviews with maternity users (n ϭ 146). Coverage of antenatal care (28%) and skilled delivery care (16%) was low. In antenatal care, preventive interventions were only partially implemented (effective iron supplementation in 17% of users). On average one minute was spent on individual counselling per consultation. 41% of pregnancies were identified as high risk and 15% received referral advice, which was followed in only 32%. Hospital deliveries accounted for 9.8% of all deliveries. Hospital-based maternal mortality was 6.8/1000 births and the stillbirth rate 70/1000. High rates of stillbirth were observed in breech delivery (258/1000 births), caesarean section (143/1000) and twin delivery (133/1000). The risk of stillbirth was higher for rural women (RR 2.3; 95% CI 1.51-3.50) and appeared to be related to low socio-economic status. Emergency admissions were rare and accounted for 3.4% of hospital deliveries or only 0.4% of all expected deliveries. There was hardly any accumulation of high-risk pregnancies at hospital. The population-based rate of caesarean section was 1.1% (urban 2.3%, rural 0.2%). The estimated unmet obstetric need was high (82 cases or 61% of expected live-threatening maternal conditions did not receive appropriate intervention). The limited effectiveness of maternity care is the result of deficiencies of all service components. We propose a two-pronged approach by starting quality improvement of maternity care from both ends of maternity services: preventive interventions for all women and hospital-based obstetric care. Antenatal screening needs to be rationalized by reducing inflated risk catalogues that result in stereotypical and often rejected referral advice. keywords safe motherhood, health systems research, maternity care, quality of care, Nepal correspondence Dr Albrecht Jahn,

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Section: Discussionmentioning

confidence: 99%

Maternity care in rural Nepal: a health service analysis

Jahn

Iang²,

Shah

et al. 2000

Tropical Med Int Health

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“…In urban Guinea-Bissau, 20 of 125 acutely ill children died either on their way to hospital or while waiting in the reception area of an outpatient clinic [6]. In Malaysia, a team assessing the value of the risk-coding system in pregnancy concluded that better communications, a more effective transport system, and better emergency care in hospitals were needed in order to reduce maternal mortality [7]. This represents empirical evidence providing emergency transport saves lives.…”

Section: Introductionmentioning

confidence: 99%

Proposing Web Based Emergency Application ( Case Study in Egypt )

Khalifa¹,

Elghany²,

Essawi³

2017

IJWMN

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“…In Guinea-Bissau, 20 of 125 acutely ill children died either on their way to hospital or while waiting in the reception area of an outpatient clinic [5]. In Malaysia, a team assessing the value of the risk coding system in pregnancy concluded that better communications, a more effective transport system, and better emergency care in hospitals were needed in order to reduce maternal mortality [6]. Karachi is a city with a population of 16 million.…”

Section: Introductionmentioning

confidence: 99%

Transport time to trauma facilities in Karachi: an exploratory study

et al. 2008

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BackgroundRapid urban growth in developing countries has outpaced the development of health infrastructure, including trauma centers, leading to potential delays in trauma care. This study was conducted in Karachi, a city of 16 million people in Pakistan.AimsOur aim was to determine the time taken to reach the nearest 24-h emergency care facility (ECF) and the government-designated trauma center (TC). We also sought to determine the availability of supplies and equipment required for “basic” trauma care at these centers.MethodsWe selected five towns in Karachi that had the highest number of road traffic injuries (RTIs) (as identified through medicolegal records). We then measured the time taken to reach the nearest ECF and the government-designated TC from four compass points within each town. We also asked about the equipment and supplies used in basic trauma care.ResultsAll three TCs in Karachi were located in the selected towns and were within 5.0–10.5 km of each other. The transport times to the 3 TCs were an average of 13.3 min (± 7.1) and to the 16 ECFs an average of 4.7 min (± 2.4) (p value < 0.00). Most ECFs did not have all equipment and supplies necessary for basic trauma care; 90% had the basic equipment for management of airway, oxygen, and IV fluids, 70% had morphine, and 45% had C-spine collars.ConclusionsVital time is lost in reaching a government-designated TC. ECFs might be an alternative option, but are not fully equipped and funded to provide adequate trauma care to all.

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Malaysian Antenatal Risk Coding and the Outcome of Pregnancy

Cited by 4 publications

References 9 publications

Maternity care in rural Nepal: a health service analysis

Maternity care in rural Nepal: a health service analysis

Proposing Web Based Emergency Application ( Case Study in Egypt )

Transport time to trauma facilities in Karachi: an exploratory study

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