Maternal death reviews at a rural hospital in Malawi

Vink, Naomi M.; Jonge, H C C de; Haar, Reynier Ter; Chizimba, Ellen M.; Stekelenburg, Jelle

doi:10.1016/j.ijgo.2012.07.028

Cited by 16 publications

(23 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Farther, lessons learned from this review indicate that, where audits are conducted, MPMMAs meeting is not regular (Van Hamersveld et al, 2012;Agaro et al, 2016;Angelo et al, 2010;Vink et al, 2013). Yet, frequent mortality meetings are an effective way of learning how to prevent maternal and perinatal deaths as well, providing opportunities for acknowledging good care/practice and management.…”

Section: Systemic and Human Factors Undermining Mpmmas Outcomes In Ssamentioning

confidence: 96%

What do we know about maternal and perinatal mortality and morbidity audits in sub-Saharan Africa? A scoping literature review

Lusambili

Jepkosgei

Nzinga

et al. 2019

IJHRH

View full text Add to dashboard Cite

Purpose -The purpose of this paper is to provide a situational overview of the facility-based maternal and perinatal morbidity and mortality audits (MPMMAs) in SSA, their current efficacy at reducing mortality and morbidity rates related to childbirth. Design/methodology/approach -This is a scoping literature review based on the synthesis of secondary literature. Findings -Not all countries in SSA conduct MPMMAs. Countries where MPMMAs are conducted have not instituted standard practice, MPMMAs are not done on a national scale, and there is no clear best practice for MPMMAs. In addition, auditing process of pediatrics and maternal deaths is flawed by human and organizational barriers. Thus, the aggregated data collected from MPMMAs are not adequate enough to identify and correct systemic flaws in SSA childbirth-related health care. Research limitations/implications -There are a few published literature on the topic in sub-Saharan Africa. Practical implications -This review exposes serious gaps in literature and practice. It provides a platform upon which practitioners and policy makers must begin to discuss ways of embedding mortality audits in SSA in their health systems as well as health strategies. Social implications -The findings of this paper can inform policy in sub-Saharan Africa that could lead toward better outcomes in health and well-being. Originality/value -The paper is original.

show abstract

Section: Systemic and Human Factors Undermining Mpmmas Outcomes In Ssamentioning

confidence: 96%

What do we know about maternal and perinatal mortality and morbidity audits in sub-Saharan Africa? A scoping literature review

Lusambili

Jepkosgei

Nzinga

et al. 2019

IJHRH

View full text Add to dashboard Cite

show abstract

“…56 A recent study of 61 maternal deaths in a central region hospital during 2007-2011 found 12 (20%) were HIV positive, 10 of whom died of non-pregnancy-related infections including meningitis and pneumonia. 57 Such non-pregnancy-related infections would be included in the pregnancy-related mortality MMR trends presented in this paper. Another recent study of 32 maternal deaths in a tertiary hospital in Malawi in 2011 found that 13 (40%) of the women were HIV positive, 9 HIV negative and 10 had an unknown HIV status and classified 6 (19%) of the maternal deaths as due to sepsis and a further 3 (9%) due to HIV-related disease.…”

Section: Hiv Aids and Artmentioning

confidence: 99%

“…25, p.140), 16% of 32 maternal deaths 58 and 17% of 61 maternal deaths. 57 With regard to malaria, although studies in other malaria endemic countries have linked seasonal trends in maternal mortality to seasonal trends in malaria incidence, 66 67 and a recent study in Kenya estimated that 9% of 249 pregnancy-related deaths were due to malaria, 68 the contribution of malaria to maternal mortality in Malawi remains unclear. Malaria control measures have increased in Malawi during the last decade of unchanged malaria transmission but have yet to reduce hospital admissions due to malaria in children.…”

Section: Malaria and Anaemiamentioning

confidence: 99%

Maternal mortality in Malawi, 1977–2012

Colbourn¹,

Lewycka²,

Nambiar³

et al. 2013

BMJ Open

View full text Add to dashboard Cite

BackgroundMillennium Development Goal 5 (MDG 5) targets a 75% reduction in maternal mortality from 1990 to 2015, yet accurate information on trends in maternal mortality and what drives them is sparse. We aimed to fill this gap for Malawi, a country in sub-Saharan Africa with high maternal mortality.MethodsWe reviewed the literature for population-based studies that provide estimates of the maternal mortality ratio (MMR) in Malawi, and for studies that list and justify variables potentially associated with trends in MMR. We used all population-based estimates of MMR representative of the whole of Malawi to construct a best-fit trend-line for the range of years with available data, calculated the proportion attributable to HIV and qualitatively analysed trends and evidence related to other covariates to logically assess likely candidate drivers of the observed trend in MMR.Results14 suitable estimates of MMR were found, covering the years 1977–2010. The resulting best-fit line predicted MMR in Malawi to have increased from 317 maternal deaths/100 000 live-births in 1980 to 748 in 1990, before peaking at 971 in 1999, and falling to 846 in 2005 and 484 in 2010. Concurrent deteriorations and improvements in HIV and health system investment and provisions are the most plausible explanations for the trend. Female literacy and education, family planning and poverty reduction could play more of a role if thresholds are passed in the coming years.ConclusionsThe decrease in MMR in Malawi is encouraging as it appears that recent efforts to control HIV and improve the health system are bearing fruit. Sustained efforts to prevent and treat maternal complications are required if Malawi is to attain the MDG 5 target and save the lives of more of its mothers in years to come.

show abstract

“…There were quite a few areas in Jinan located in the mountains. When intractable illness of maternal women occurred in county-level medical institutions, inconvenient transportation undoubtedly increased transit time and further increased the risk of death [16,17] . This situation was particularly prominent in the 1990s.…”

Section: Discussionmentioning

confidence: 99%

Differences in maternal mortality between urban and rural areas: Analysis of Maternal Mortality based in Jinan, China in 1995- 2018

Zhang¹,

Zheng²,

Meng³

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: Although a large number of studies have shown that maternal mortality in rural areas is higher than that in urban areas, few reports discussed about the detailed situation and the behind causes. Here, we summarized the maternal mortality from 1995 to 2018 in Jinan and the reason behind it was deeply discussed. It is expected to reveal the difference and its behind reasons, thus providing a basis for policy makers to develop interventions. Methods: Data about maternal mortality in the selected city from 1995 to 2018 were collected through the local maternal and child health care network. Maternal death age, maternal death delivery location, maternal death location, number of pregnancies, number of deliveries and maternal death causes were analyzed. The composition ratio of above factors were compared in order to indicate the differences between rural areas and urban areas. Results: The study showed that 75.34% of maternal deaths in urban areas occurred in tertiary hospitals, which were 2.13 times higher than that in rural areas(P<0.05). 16.67% of maternal deaths in rural areas delivered in primary hospitals, which were 12.17 times higher than that in urban areas (P<0.05) . The main cause of death in rural areas were attributed to direct obstetrics reasons, which were indirect obstetric reasons for urban areas (P<0.05). There was no difference of maternal deaths in the death age, number of births, and number of pregnancies between rural areas and urban areas.(P>0.05) Conclusion: Policy makers should focus on the construction of medical institutions in rural areas, the improvement of rescue capabilities in rural areas and the convenience of transport in rural areas in order to narrow the gap between rural and urban areas. Key words: Maternal Mortality; Differences between urban and rural areas; China

show abstract

Maternal death reviews at a rural hospital in Malawi

Abstract: Most maternal deaths had indirect causes and were associated with delays in all phases. An audit makes clear which part of the referral chain needs to be strengthened. Nkhoma CCAP Hospital has taken steps to address all phases of delay.

Cited by 16 publications

References 12 publications

What do we know about maternal and perinatal mortality and morbidity audits in sub-Saharan Africa? A scoping literature review

What do we know about maternal and perinatal mortality and morbidity audits in sub-Saharan Africa? A scoping literature review

Maternal mortality in Malawi, 1977–2012

Differences in maternal mortality between urban and rural areas: Analysis of Maternal Mortality based in Jinan, China in 1995- 2018

Contact Info

Product

Resources

About