Trends in maternal mortality in Suriname: 3 confidential enquiries in 3 decades

Kodan, Lachmi R.; Verschueren, Kim J.C.; Paidin, Raëz R.; Paidin, Rubinah R.; Browne, Joyce L.; Bloemenkamp, Kitty W. M.; Rijken, Marcus J.

doi:10.1016/j.xagr.2021.100004

Cited by 5 publications

(1 citation statement)

References 28 publications

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“…Hypertension during pregnancy manifests in many forms and elicits a wide array of risks to the fetal and maternal health. 1,2 Apart from being detrimental to fetal health, pregnancy induced hypertension (PIH) takes an estimated toll of 287000 maternal deaths annually. Key statistics (morbidity, mortality, and life-time risk) vary across different regions.…”

Section: Introductionmentioning

confidence: 99%

Fetomaternal Outcomes of Pregnancy among Women suffering from Chronic hypertension

Nayab¹,

Khowaja²,

Memon³

et al. 2022

JAFMDC

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Objective: To observe the association of chronic hypertension in pregnant women on their health and fetal outcome. Methodology: This cross-sectional study was carried out from September 2019 to September 2020 upon a sample of 183 consenting pregnant women (chosen via non-probability – consecutive sampling) aged 20 – 35 years admitted to the study setting via OPD and emergency at Gynae Unit IV, Liaquat University of Medical & Health Sciences, Jamshoro (LUMHS). The data obtained was recorded on structured questionnaire comprising of inquiries pertaining to basic biodata, sociodemographic details, inferences obtained from history, clinical examination, and blood pressure. Data obtained was analyzed using SPSS V. 21.0. Results: The mean age of the women was 24 years ±3 SD. The mean gestational age was 38 weeks (±1 SD). A majority of the participants hailed from an urban background and most presented as booked elective cases (normal delivery more often than cesarean delivery). Chronic hypertension (mean value 134/92) was present among 38.8% of the study participants. Poor maternal and fetal outcome were encountered among patients with chronic hypertension. Conclusion: A heavy burden of chronic hypertension was unearthed by this study which consisted of around 2/5th of whole sample. Adverse maternal outcomes including postpartum hemorrhage, eclampsia & spontaneous abortion and fetal (low birth weight & neonatal deaths complications were strongly associated with chronic hypertension.

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Section: Introductionmentioning

confidence: 99%

Fetomaternal Outcomes of Pregnancy among Women suffering from Chronic hypertension

Nayab¹,

Khowaja²,

Memon³

et al. 2022

JAFMDC

View full text Add to dashboard Cite

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Anticipated benefits and challenges of implementing group care in Suriname’s maternity and child care sector: a contextual analysis

Martens,

Hindori-Mohangoo,

Hindori

et al. 2023

BMC Pregnancy Childbirth

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Background Suriname is a uppermiddle-income country with a relatively high prevalence of preventable pregnancy complications. Access to and usage of high-quality maternity care services are lacking. The implementation of group care (GC) may yield maternal and child health improvements. However, before introducing a complex intervention it is pivotal to develop an understanding of the local context to inform the implementation process. Methods A context analysis was conducted to identify local needs toward maternity and postnatal care services, and to assess contextual factor relevant to implementability of GC. During a Rapid Qualitative Inquiry, 63 online and face-to-face semi-structured interviews were held with parents, community members, on-and off-site healthcare professionals, policy makers, and one focus group with parents was conducted. Audio recordings were transcribed in verbatim and analysed using thematic analysis and Framework Method. The Consolidated Framework for Implementation Research served as a base for the coding tree, which was complemented with inductively derived codes. Results Ten themes related to implementability, one theme related to sustainability, and seven themes related to reaching and participation of the target population in GC were identified. Factors related to health care professionals (e.g., workload, compatibility, ownership, role clarity), to GC, to recipients and to planning impact the implementability of GC, while sustainability is in particular hampered by sparse financial and human resources. Reach affects both implementability and sustainability. Yet, outer setting and attitudinal barriers of health professionals will likely affect reach. Conclusions Multi-layered contextual factors impact not only implementability and sustainability of GC, but also reach of parents. We advise future researchers and implementors of GC to investigate not only determinants for implementability and sustainability, but also those factors that may hamper, or facilitate up-take. Practical, attitudinal and cultural barriers to GC participation need to be examined. Themes identified in this study will inspire the development of adaptations and implementation strategies at a later stage.

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Implementing group care in Dutch and Surinamese maternity and child care services: the vital importance of addressing outer context barriers

Martens,

Haverkate,

Hindori-Mohangoo

et al. 2024

BMC Pregnancy Childbirth

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Background By addressing physical and psychosocial needs, group care (GC) improves health-related behaviours, peer support, parent-provider interactions and may improve birth outcomes. Hence, global implementation of GC is encouraged. Context analyses prior to implementation are vital to elucidate which local factors may support or hinder implementation. Methods Contextual analyses conducted in the Netherlands and Suriname were compared to identify the factors relevant to the implementability of GC as perceived by healthcare professionals (HCPs). 32 semi-structured interviews were conducted with Dutch and Surinamese healthcare professionals. Audio recordings were transcribed verbatim and coded using the Framework approach. The Consolidated Framework for Implementation Research guided the development of the interview guide and of the coding tree. Results Outer setting: Concerns regarding funding surfaced in both countries. Due to limited health insurance coverage, additional fees would limit accessibility in Suriname. In the Netherlands, midwives dreaded lower revenue due to reimbursement policies that favour one-on-one care. Inner setting: Appropriate space for GC was absent in one Dutch and three Surinamese facilities. Role division regarding GC implementation was clearer in the Netherlands than in Suriname. Innovation: HCPs from both countries expected increased social support, health knowledge among women, and continuity of care(r). Individuals/innovation deliverers: Self-efficacy and motivation emerged as intertwined determinants to GC implementation in both countries. Individuals/innovation recipients: Competing demands can potentially lower acceptability of GC in both countries. While Dutch HCPs prioritised an open dialogue with mothers, Surinamese HCPs encouraged the inclusion of partners. Process: Campaigns to raise awareness of GC were proposed. Language barriers were a concern for Dutch but not for Surinamese HCPs. Conclusions While the most striking differences between both countries were found in the outer setting, they trickle down and affect all layers of context. Ultimately, at a later stage, the process evaluation will show if those outer setting barriers we identified prior to implementation actually hindered GC implementation. Changes to the health care systems would ensure sustained implementation in both countries, and this conclusion feeds into a more general discussion: how to proceed when contextual analyses reveal barriers that cannot be addressed with the time and resources available.

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Trends in maternal mortality in Suriname: 3 confidential enquiries in 3 decades

Cited by 5 publications

References 28 publications

Fetomaternal Outcomes of Pregnancy among Women suffering from Chronic hypertension

Fetomaternal Outcomes of Pregnancy among Women suffering from Chronic hypertension

Anticipated benefits and challenges of implementing group care in Suriname’s maternity and child care sector: a contextual analysis

Implementing group care in Dutch and Surinamese maternity and child care services: the vital importance of addressing outer context barriers

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