Towards renewed commitment to prevent maternal mortality and morbidity: learning from 30 years of maternal health priorities

Miltenburg, Andrea Solnes; Kvernflaten, Birgit; Meguid, Tarek; Sundby, Johanne

doi:10.1080/26410397.2023.2174245

Cited by 3 publications

(2 citation statements)

References 60 publications

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“…Koblinsky et al [45] described four models of care: home deliveries by community members (Model 1), home deliveries by a professional attendant (doctor or midwife) (Model 2), delivery by professional attendants in a basic Essential Obstetric Care (EOC) facility (Model 3), and delivery by professionals in a comprehensive EOC facility (Model 4). When reviewing the last 30 years (1987-2017), the promoted model of care within low-resource settings has progressed from Models 1 and 2 in the first decade to Model 4 in the third decade [46]. Each country should choose the appropriate strategy in different social and cultural contexts.…”

Section: Toward Universal Maternal Health Coverage: Progress and Gapmentioning

confidence: 99%

Changes and Determinants of Maternal Health Services Utilization in Ethnic Minority Rural Areas in Central China, 1991–2015: An Ecological Systems Theory Perspective

Zhang

Lü

2023

Healthcare

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Background: Universal maternal health coverage is a proven, effective strategy for maternal survival. This study aimed to describe the changes and determinants of maternal health service use between 1991 and 2015 in central China. Methods: The study was conducted in Enshi Prefecture. Women were eligible for inclusion if they were rural women who lived in villages, had live births during 1991–2015, could recall their maternal care histories, and had no communication problems. This retrospective study included 470 rural women in 9 villages and collected 770 records. The conceptual framework was designed based on the Society Ecosystem Theory. The determinants included micro-factors (individual characteristics), meso-factors (family factors, community factors, healthcare factors), and macro-factors (government-run maternal and child health programs, abbreviated as MCH programs). Multivariate logistic regressions were applied to analyze the determinants of maternal health service utilization. Results: The utilization of maternal healthcare has improved in Enshi. The hospital birth rate was 98.1% in 2009 and mostly 100% in subsequent years. The prenatal examination rate, the postpartum visit rate, and the continuum of maternal health service (CMHS) rate increased to 73.3%, 67.7%, and 53.4%, respectively, in 2009–2015. The utilization of maternal health services was affected by macro-factors, meso-factors, and micro-factors, with macro-factors being the most notable contributors. Conclusions: Despite the remarkable improvements in antenatal care (ANC) use and hospital birth, gaps in postpartum visits remain. Promoting the integrated continuum of maternal and child healthcare in ethnic minority rural areas requires the joint efforts of the government, health and other sectors, communities, families, and individuals.

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Section: Toward Universal Maternal Health Coverage: Progress and Gapmentioning

confidence: 99%

Changes and Determinants of Maternal Health Services Utilization in Ethnic Minority Rural Areas in Central China, 1991–2015: An Ecological Systems Theory Perspective

Zhang

Lü

2023

Healthcare

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“…In light of this matter, it is feasible to provide communities with timely and high-quality services to address the pressing challenges of reducing maternal mortality. This is especially vital for low-income countries [ 15 ], as it can substantially contribute to the improvement of public health. Therefore, this study aims to determine the main barriers to the provision and utilization of MH services in low- and lower-middle-income countries (LLMICs), using a scoping review approach.…”

Section: Introductionmentioning

confidence: 99%

Key barriers to the provision and utilization of maternal health services in low-and lower-middle-income countries; a scoping review

Sarikhani,

Najibi,

Razavi

2024

BMC Women's Health

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Background The preservation and promotion of maternal health (MH) emerge as vital global health objectives. Despite the considerable emphasis on MH, there are still serious challenges to equitable access to MH services in many countries. This review aimed to determine key barriers to the provision and utilization of MH services in low- and lower-middle-income countries (LLMICs). Methods In this scoping review, we comprehensively searched four online databases from January 2000 to September 2022. In this study, the approach proposed by Arksey and O’Malley was used to perform the review. Consequently, 117 studies were selected for final analysis. To determine eligibility, three criteria of scoping reviews (population, concept, and context) were assessed alongside the fulfillment of the STROBE and CASP checklist criteria. To synthesize and analyze the extracted data we used the qualitative content analysis method. Results The main challenges in the utilization of MH services in LLMICs are explained under four main themes including, knowledge barriers, barriers related to beliefs, attitudes and preferences, access barriers, and barriers related to family structure and power. Furthermore, the main barriers to the provision of MH services in these countries have been categorized into three main themes including, resource, equipment, and capital constraints, human resource barriers, and process defects in the provision of services. Conclusions The evidence from this study suggests that many of the barriers to the provision and utilization of MH services in LLMICs are interrelated. Therefore, in the first step, it is necessary to prioritize these factors by determining their relative importance according to the specific conditions of each country. Consequently, comprehensive policies should be developed using system modeling approaches.

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Trends, epidemiology and causes of maternal deaths over a decade (2013-2022) in a context of crisis among 8 health zones in Eastern Democratic Republic of Congo

Mwene-Batu,

Ndokabilya,

Lembebu

et al. 2024

Preprint

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Background Maternal mortality (MM) remains a real scourge that hits hardest in the poorest regions of the world, particularly those affected by conflict. However, despite this worrying reality, few studies have been conducted about MM in the Democratic Republic of Congo (DRC). The study aimed to describe the trends as well as the epidemiological profile and causes of maternal deaths between 2013 and 2022 in Eastern DRC. Methods A cross-sectional study was conducted between March 2023 and August 2023 in eight Health Zones (HZ), five in South Kivu Province (Mwana, Minova, Miti-Murhesa, Kamituga and Idjwi) and three in North Kivu Province (Kirotshe, Karisimbi and Kayna) in the eastern region of the DRC. Data from registers and medical records of maternal deaths recorded in these zones over the last 10 years (2013–2022) were extracted along with information on the number of deliveries and live births. Differences in sociodemographic, clinical parameters, Blood and ultrasound tests and suspected causes of death between provinces were assessed using chi-square and non-parametric Wilcoxon-Mann-Whitney tests, with a 5% significance level. RESULTS From 2013 to 2022, the study sites experienced two significant drops in MMR (in 2015 and 2018), and a spike in 2016–2017. Nonetheless, the combined MMR (across study sites) started and ended the 10-year study period at approximately the same level (53 in 2013 and 57 in 2022). Overall, 62,6% of the deaths were reported from secondary hospital. Most deaths were of married women in their thirties (93.5%). Almost 47.8% had not completed four antenatal consultations (ANC). The main direct causes of death were, in decreasing order of frequency: post-partum haemorrhage (55.2%), uterine rupture (14.0), hypertensive disorders (8.4%), abortions (7.7%) puerperal infections (2.8%) and placental abruption (0.7%).When comparing among provinces, reported abortion-related maternal mortality (14.1% vs 0%, p = 0,001) was significantly more frequent in North Kivu than in South Kivu. CONCLUSION This study imperatively highlights the need for targeted interventions to reduce maternal mortality. By emphasizing the crucial importance of antenatal consultations, intrapartum/immediate post-partum care and quality of care, significant progress can be made in guaranteeing maternal health and reducing many avoidable deaths.

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Towards renewed commitment to prevent maternal mortality and morbidity: learning from 30 years of maternal health priorities

Cited by 3 publications

References 60 publications

Changes and Determinants of Maternal Health Services Utilization in Ethnic Minority Rural Areas in Central China, 1991–2015: An Ecological Systems Theory Perspective

Changes and Determinants of Maternal Health Services Utilization in Ethnic Minority Rural Areas in Central China, 1991–2015: An Ecological Systems Theory Perspective

Key barriers to the provision and utilization of maternal health services in low-and lower-middle-income countries; a scoping review

Trends, epidemiology and causes of maternal deaths over a decade (2013-2022) in a context of crisis among 8 health zones in Eastern Democratic Republic of Congo

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