Poor quality for poor women? Inequities in the quality of antenatal and delivery care in Kenya
Background: Quality of healthcare is an important determinant of future progress in global health. However, the distributional aspects of quality of care have received inadequate attention. We assessed whether high quality maternal care is equitably distributed by (1) mapping the quality of maternal care in facilities located in poorer versus wealthier areas of Kenya; and […]
Maternal mortality in Ghana: A hospital-based review
Objective. This study examines the leading causes of maternal mortality in Ghana, classifies the main causes of maternal deaths and suggests how maternal care can be improved. Design. Retrospective review. Setting. Komfo Anokye Teaching Hospital, Ghana. Sample. Three hundred and twenty-two maternal deaths with 30 269 live births in the period 1 January 2008 to […]
Effect of health systems strengthening in influencing maternal and neonatal health outcomes in Bungoma County, Kenya
Introduction: maternal and neonatal health status indicators have steadily improved over time in Kenya. Significant challenges remain, including persistent inequities between population subgroups, and a health system that delivers variable quality care and inconsistent access to care. This paper highlights results of an ex-post evaluation to assess the impact of maternal and health systems strengthening […]
Improving access to maternal health services among rural hard-to-reach fishing communities in Uganda, the role of community health workers
Objectives: To explore whether community health worker household-based maternal health visits improve antenatal care and skilled birth attendance among hard-to-reach fishing villages on Lake Victoria, Uganda. Methods: This quasi-experimental 18-month prospective study involved 486 consenting women aged 15–49 years, who were pregnant or had a pregnancy outcome in the past 6 months, from 6 island […]
Increased access to antiretroviral therapy is associated with reduced maternal mortality in Johannesburg, South Africa: An Audit from 2003-2012
Objective: To assess the impact of expanded access to antiretroviral treatment (ART) on maternal mortality in Johannesburg, South Africa between 2003 and 2012. Methods: Audit of patient files, birth registers and death certificates at a tertiary level referral hospital. Cause of death was assigned independently, by two reviewers. We compared causes of deaths and the […]
The PRECISE (PREgnancy Care Integrating translational Science, Everywhere) database: Open-access data collection in maternal and newborn health
In less-resourced settings, adverse pregnancy outcome rates are unacceptably high. To effect improvement, we need accurate epidemiological data about rates of death and morbidity, as well as social determinants of health and processes of care, and from each country (or region) to contextualise strategies. The PRECISE database is a unique core infrastructure of a generic, […]
Geographical access to point-of-care testing for hypertensive disorders of pregnancy as an integral part of maternal healthcare in Ghana
Background: Hypertensive disorders of pregnancy (HDP) are associated with high maternal mortality in Ghana and globally. Evidence shows that there is poor availability of pregnancy-related point-of-care (POC) tests in Ghana’s primary healthcare (PHC) clinics (health centre or community-based health planning services facilities). Therefore, we employed geographic information systems to estimate the geographical distribution of and […]
