Maternal mortality in rural south ethiopia: Outcomes of community-based birth registration by health extension workers
Introduction Rural communities in low-income countries lack vital registrations to track birth outcomes. We aimed to examine the feasibility of community-based birth registration and measure maternal mortality ratio (MMR) in rural south Ethiopia. Methods In 2010, health extension workers (HEWs) registered births and maternal deaths among 421,639 people in three districts (Derashe, Bonke, and Arba […]
Institutional maternal and perinatal deaths: A review of 40 low and middle income countries
Background: Understanding the magnitude and clinical causes of maternal and perinatal mortality are basic requirements for positive change. Facility-based information offers a contextualized resource for clinical and organizational quality improvement. We describe the magnitude of institutional maternal mortality, causes of death and cause-specific case fatality rates, as well as stillbirth and pre-discharge neonatal death rates. […]
Challenges to improve antenatal and intrapartum care in South Africa
The major causes of maternal and perinatal deaths have been well described in South Africa. These causes are related to HIV infection, placental insufficiency and intrapartum asphyxia. The health system failures that most commonly lead to preventable mortality are related to managing hypertensive disorders in pregnancy (HDP), detecting fetal growth restriction antenatally and managing labour […]
Indirect effects of COVID-19 on maternal, neonatal, child, sexual and reproductive health services in Kampala, Uganda
Background COVID-19 impacted global maternal, neonatal and child health outcomes. We hypothesised that the early, strict lockdown that restricted individuals’ movements in Uganda limited access to services. Methods An observational study, using routinely collected data from Electronic Medical Records, was carried out, in Kawempe district, Kampala. An interrupted time series analysis assessed the impact on […]
Near-miss maternal morbidity from severe haemorrhage at caesarean section: A process and structure audit of system deficiencies in South Africa
Background. A rising caesarean section rate and substandard peri-operative care are believed to be the main reasons for recent increases in maternal deaths from bleeding during and after caesarean section (BDACS) in South Africa (SA). The Donabedian model assumes that clinical outcomes are influenced by healthcare workers and the healthcare system. Objectives. To evaluate near-miss […]
Delays in receiving obstetric care and poor maternal outcomes: Results from a national multicentre cross-sectional study
Background: The vast majority of maternal deaths in low-and middle-income countries are preventable. Delay in obtaining access to appropriate health care is a fairly common problem which can be improved. The objective of this study was to explore the association between delay in providing obstetric health care and severe maternal morbidity/death.Methods: This was a multicentre […]
Piecing Together the Maternal Death Puzzle through Narratives: The Three Delays Model Revisited
Background: In Malawi maternal mortality continues to be a major public health challenge. Going beyond the numbers to form a more complete view of why women die is critical to improving access to and quality of emergency obstetric care. The objective of the current study was to identify the socio-cultural and facility-based factors that contributed […]
A ketamine package for use in emergency cesarean delivery when no anesthetist is available: An analysis of 401 consecutive operations
Objective: To evaluate the safety and effectiveness of a ketamine-based anesthesia package to support emergency cesarean section when no anesthetist is available. Methods: A prospective case-series was conducted between December 11, 2013 and September 30, 2021 across nine sub-county hospitals in Kenya. Non-anesthetist healthcare providers undertook an evidence-based five-day training course. A structured instrument was […]
Maternal overweight and obesity and the risk of caesarean birth in Malawi
Background: Overweight and obese women are at risk of pregnancy and delivery complications. This study investigates the trend and association between maternal overweight and obesity on caesarean births in Malawi. Methods: We utilised cross-sectional population-based Demographic Health Surveys (DHSs) data collected from mothers aged 18-49 years in 2004/05, 2010, and 2015/16 in Malawi. The outcome […]
Health & Demographic Surveillance System Profile: The Ifakara Rural and Urban Health and Demographic Surveillance System (Ifakara HDSS)
The Ifakara Rural HDSS (125 000 people) was set up in 1996 for a trial of the effectiveness of social marketing of bed nets on morbidity and mortality of children aged under 5 years, whereas the Ifakara Urban HDSS (45 000 people) since 2007 has provided demographic indicators for a typical small urban centre setting. […]
