Cervical dilatation over time is a poor predictor of severe adverse birth outcomes: a diagnostic accuracy study
Objective: To assess the accuracy of the World Health Organization (WHO) partograph alert line and other candidate predictors in the identification of women at risk of developing severe adverse birth outcomes. Design: A facility-based, multicentre, prospective cohort study. Setting: Thirteen maternity hospitals located in Nigeria and Uganda. Population: A total of 9995 women with spontaneous […]
Neonatal Mortality and Education Related Inequality in Cesarean Births in Sub-Saharan Africa: Multi-Country Propensity Score Matching and Meta-Analysis
Background: Sub-Saharan African (SSA) newborns are ten times more likely to die in the first month than a neonate born in a high-income country. The objective of this study was to examine the relationship between educational attainment and neonatal mortality (NM) among women with cesarean section (CS) deliveries in SSA countries. Methods: Using data from […]
Improving pregnant women’s knowledge on danger signs and birth preparedness practices using an interactive mobile messaging alert system in Dodoma region, Tanzania: a controlled quasi experimental study
Background: Unacceptably high maternal and perinatal mortality remain a major challenge in many low income countries. Early detection and management of danger signs through improved access to maternal services is highly needed for better maternal and infant outcomes. The aim of this study was to test the effectiveness of an interactive mobile messaging alert system […]
Spatial variation and inequities in antenatal care coverage in Kenya, Uganda and mainland Tanzania using model-based geostatistics: a socioeconomic and geographical accessibility lens
Background: Pregnant women in sub-Saharan Africa (SSA) experience the highest levels of maternal mortality and stillbirths due to predominantly avoidable causes. Antenatal care (ANC) can prevent, detect, alleviate, or manage these causes. While eight ANC contacts are now recommended, coverage of the previous minimum of four visits (ANC4+) remains low and inequitable in SSA. Methods: […]
Temporal trends in spatial inequalities of maternal and newborn health services among four east African countries, 1999-2015
Background: Sub-Saharan Africa continues to account for the highest regional maternal mortality ratio (MMR) in the world, at just under 550 maternal deaths per 100,000 live births in 2015, compared to a global rate of 216 deaths. Spatial inequalities in access to life-saving maternal and newborn health (MNH) services persist within sub-Saharan Africa, however, with […]
Impact of malaria during pregnancy on pregnancy outcomes in a Ugandan prospective cohort with intensive malaria screening and prompt treatment
Background: Malaria in pregnancy (MiP) is a major public health problem in endemic areas of sub-Saharan Africa and has important consequences on birth outcome. Because MiP is a complex phenomenon and malaria epidemiology is rapidly changing, additional evidence is still required to understand how best to control malaria. This study followed a prospective cohort of […]
Development of a district mental healthcare plan in Uganda
Background Evidence is needed for the integration of mental health into primary care advocated by the national health sector strategic investment plan in Uganda. Aims To describe the processes of developing a district mental healthcare plan (MHCP) in rural Uganda that facilitates integration of mental health into primary care. Method Mixed methods using a situational […]
Intra-facility linkage of HIV-positive mothers and HIV-exposed babies into HIV chronic care: Rural and urban experience in a resource limited setting
Introduction: Linkage of HIV-infected pregnant women to HIV care remains critical for improvement of maternal and child outcomes through prevention of maternal-to-child transmission of HIV (PMTCT) and subsequent chronic HIV care. This study determined proportions and factors associated with intra-facility linkage to HIV care and Early Infant Diagnosis care (EID) to inform strategic scale up […]
A mixed-methods study of maternal health care utilisation in six referral hospitals in four sub-Saharan African countries before and during the COVID-19 pandemic
Introduction In sub-Saharan Africa, referral hospitals are important sources of key maternal health services, especially during a crisis such as the COVID-19 pandemic. This study prospectively assessed the effect of the COVID-19 pandemic on maternal health service utilisation in six large referral hospitals in Guinea, Nigeria, Tanzania and Uganda during the first year of the […]
Applying a system dynamics modelling approach to explore policy options for improving neonatal health in Uganda
Background: The most recent reports on global trends in neonatal mortality continue to show alarmingly slow progress on improvements in neonatal mortality rates, with sub-Saharan Africa still lagging behind. This emphasised the urgent need to innovatively employ alternative solutions that take into account the intricate complexities of neonatal health and the health systems in which […]
