Safe recovery after cesarean in rural Africa: Technical consensus guidelines for post‐discharge care

Kateera, Fredrick; Hedt‐Gauthier, Bethany; Luo, Amy; Niyigena, Anne; Galvin, Grace; Hakizimana, Sadoscar; Molina, Rose L.; Boatin, Adeline A.; Kasonde, Prisca; Musabeyezu, Juliet; Ngonzi, Joseph; Riviello, Robert; Semrau, Katherine; Sayinzoga, Félix

doi:10.1002/ijgo.14284

Cited by 4 publications

(2 citation statements)

References 41 publications

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“…Additionally, we found that after C-s, women refrain from eating solid and semisolid foods owing to the belief that eating will cause wound-related complications. In Africa, the typical surgical wound is healed on the third postoperative day to a sufficient extent that a woman is discharged and eating is permitted at any time after surgery when the woman feels hungry 36. The health talk messages emphasise the prevention of potential infections during bathing, dressing and physical activities, as well as the maintenance of nutritious diet with a variety of food groups for safe recovery, the restoration of normal bowel function and the support of breast feeding.…”

Section: Discussionmentioning

confidence: 99%

Local knowledge and derived practices of safety during pregnancy, childbirth and postpartum: a qualitative study among nurse-midwives in urban eastern Tanzania

et al. 2022

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BackgroundMaternal and newborn mortality are still high in low-income and middle-income countries despite global efforts to improve the quality of care by prioritising evidence-based practices and increasing the number of births attended by skilled personnel. During childbirth, women are hesitant to use the health facility services. Concerns about safety and risks during pregnancy, childbirth and postpartum period are deeply rooted in local health practices and beliefs.ObjectiveThe aim of this study was to explore the perceptions of local health knowledge and derived practices among nurse-midwives in urban eastern Tanzania.MethodsAn exploratory qualitative study design was carried out in a district hospital in eastern Tanzania. Twenty-one nurse-midwives participated in two focus group discussions. The data were analysed using qualitative content analysis.ResultsBased on existing scientific data, local knowledge and derived practices were categorised as potentially beneficial, neither beneficial nor harmful and potentially harmful. Our study identified a wide range of local knowledge and derived practices used by women. These include to refrain from shouting or crying to prevent exhaustion during labour, drinks and foods restrictions during labour and after birth, and use of local herbs to stimulate labour. In addition, midwives reinforced the importance of integrating local knowledge and practices with potential benefits with evidence-based practices. Encouraging and listening to women would offer an opportunity to reduce harmful practices.ConclusionsWhile non-harmful and beneficial practices for ensuring safety during pregnancy, childbirth and postpartum period should be accepted and supported as a part of our cultural richness, harmful practices should be discouraged. This can be achieved through antenatal health education and afterbirth health messages on hospital discharge to promote positive childbirth health outcomes.

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Section: Discussionmentioning

confidence: 99%

Local knowledge and derived practices of safety during pregnancy, childbirth and postpartum: a qualitative study among nurse-midwives in urban eastern Tanzania

et al. 2022

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“…This is contrary to developed countries, where home visits and surveillance for post-CS mothers are routinely conducted [ 13 ]. Studies report a complete lack of or less information regarding home care after CS compared to home care after vaginaly delivery [ 23 , 24 ]. The limited available information about home care after CS highly varies among different sources across the region [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Protocol for designing and testing the effectiveness of a post caesarean section home care guide in preventing surgical site infection in Central Tanzania

2023

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Background The advantages of caesarean section (CS) in managing obstetric emergencies are abundant, but it is associated with several complications including surgical site infection (SSI). SSI significantly contributes to maternal morbidity and mortality rates. Mothers often do not receive adequate information about their at-home post-delivery care. Also, guidelines on post-CS care worldwide typically do not include home care recommendations. Because of the increased rate of CS and space constraints in the hospitals, mothers are often discharged home within 48 hours after CS. Therefore, it is anticipated that using an evidence-based home care guide would provide instruction to the mothers and is likely to prevent postpartum complications and promote the well-being of both the mother and the newborn. Aim To design and test the effectiveness of a post-CS home care guide in preventing SSI in central Tanzania. Methodology This is a sequential exploratory mixed-method interventional study conducted in two regional referral hospitals in central Tanzania. A qualitative study will be conducted to explore the experiences of nurse midwives, mothers who had caesarean deliveries and their caretakers regarding the care of mothers and newborns at home. The findings will inform the development of a post-CS home care guide. Following a series of validations of the guide, research assistants will employ the guidelines to instruct post-CS mothers about home care as part of the intervention. Thirty participants will purposively be recruited for the qualitative study and a random sample of 248 nurse-midwives and 414 post-CS mothers to assess the effectiveness of the guide in improving knowledge of home care and preventing SSI. SPSS version 25 will be used to analyse quantitative data and content analysis, and ATLAS.ti will guide in analysing the qualitative data. Conclusion The post-CS home care guide will provide instructions to post-CS mothers and their caretakers about the care of the mothers after CS to enhance their recovery.

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Safe recovery after cesarean in rural Africa: Technical consensus guidelines for post‐discharge care

Kateera

Hedt‐Gauthier

Luo

et al. 2022

Intl J Gynecology & Obste

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Despite increasing cesarean rates in Africa, there remain extensive gaps in the standard provision of care after cesarean birth. We present recommendations for discharge instructions to be provided to women following cesarean delivery in Rwanda, particularly rural Rwanda, and with consideration of adaptable guidelines for sub-Saharan Africa, to support recovery during the postpartum period. These guidelines were developed by a Technical Advisory Group comprised of clinical, program, policy, and research experts with extensive knowledge of cesarean care in Africa. The final instructions delineate between normal and abnormal recovery symptoms and advise when to seek care. The instructions align with global postpartum care guidelines, with additional emphasis on care practices more common in the region and address barriers that women delivering via cesarean may encounter in Africa. The recommended | 13 KATEERA ET Al.

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Safe recovery after cesarean in rural Africa: Technical consensus guidelines for post‐discharge care

Cited by 4 publications

References 41 publications

Local knowledge and derived practices of safety during pregnancy, childbirth and postpartum: a qualitative study among nurse-midwives in urban eastern Tanzania

Local knowledge and derived practices of safety during pregnancy, childbirth and postpartum: a qualitative study among nurse-midwives in urban eastern Tanzania

Protocol for designing and testing the effectiveness of a post caesarean section home care guide in preventing surgical site infection in Central Tanzania

Safe recovery after cesarean in rural Africa: Technical consensus guidelines for post‐discharge care

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