Mobilizing communities to improve maternal health: Results of an intervention in rural Zambia
Objective: To determine whether a complex community intervention in rural Zambia improved understanding of maternal health and increased use of maternal health-care services. Methods: The intervention took place in six rural districts selected by the Zambian Ministry of Health. It involved community discussions on safe pregnancy and delivery led by trained volunteers and the provision […]
Effect of a novel vital sign device on maternal mortality and morbidity in low-resource settings: a pragmatic, stepped-wedge, cluster-randomised controlled trial
Background: In 2015, an estimated 303 000 women died in pregnancy and childbirth. Obstetric haemorrhage, sepsis, and hypertensive disorders of pregnancy account for more than 50% of maternal deaths worldwide. There are effective treatments for these pregnancy complications, but they require early detection by measurement of vital signs and timely administration to save lives. The […]
The cost-effectiveness of using results-based financing to reduce maternal and perinatal mortality in Malawi
Introduction Results-based financing (RBF) is being promoted to increase coverage and quality of maternal and perinatal healthcare in sub-Saharan Africa (SSA) countries. Evidence on the cost-effectiveness of RBF is limited. We assessed the cost-effectiveness within the context of an RBF intervention, including performance-based financing and conditional cash transfers, in rural Malawi. Methods We used a […]
Does knowledge about antiretroviral therapy and mother-to-child transmission affect the relationships between HIV status and fertility preferences and contraceptive use? New evidence from Nigeria and Zambia
Summary The increasing availability of antiretroviral therapy (ART) and drug regimens to prevent mother-to-child transmission (PMTCT) has probably changed the context of childbearing for people living with HIV. Using data from 2009-2010 community-based surveys in Nigeria and Zambia, this study explores whether women’s knowledge about ART and PMTCT influences the relationship between HIV status and […]
A risk score to identify hiv-infected women most likely to become lost to follow-up in the postpartum period
Access to lifelong combination antiretroviral therapy (cART) is expanding among HIV-infected pregnant and breastfeeding women throughout sub-Saharan Africa (SSA). For this strategy to meaningfully improve maternal HIV outcomes, retention in HIV care is essential. We developed a risk score to identify women with high likelihood of loss to follow-up (LTFU) at 6 months postpartum from […]
The tipping point of antenatal engagement: A qualitative grounded theory in Tanzania and Zambia
Background: Effective antenatal care is fundamental to the promotion of positive maternal and new-born outcomes. International guidance recommends an initial visit in the first trimester of pregnancy, with a minimum of four antenatal visits in total: the optimum schedule being eight antenatal contacts. In low- and middle-income countries, many women do not access antenatal care […]
Signal functions for emergency obstetric care as an intervention for reducing maternal mortality: A survey of public and private health facilities in Lusaka District, Zambia
Background: Zambia’s maternal mortality ratio was estimated at 398/100,000 live births in 2014. Successful aversion of deaths is dependent on availability and usability of signal functions for emergency obstetric and neonatal care. Evidence of availability, usability and quality of signal functions in urban settings in Zambia is minimal as previous research has evaluated their distribution […]
Abuse and disrespectful care on women during access to antenatal care services and its implications in Ndola and Kitwe health facilities
Background: Antenatal care utilization is fundamental in preventing adverse pregnancy and birth outcomes. This paper assessed abuse and disrespectful care on women during access to antenatal care services and its implications in Ndola and Kitwe districts of Zambia. Methods: The assessment used a cross-sectional study design with a sample size of 505 women of child […]
Health care in pregnancy during the COVID-19 pandemic and pregnancy outcomes in six low- and-middle-income countries: Evidence from a prospective, observational registry of the Global Network for Women’s and Children’s Health
Objective: To assess, on a population basis, the medical care for pregnant women in specific geographic regions of six countries before and during the first year of the coronavirus disease 2019 (COVID-19) pandemic in relationship to pregnancy outcomes. Design: Prospective, population-based study. Setting: Communities in Kenya, Zambia, the Democratic Republic of the Congo, Pakistan, India […]
Local problems; Local solutions: An innovative approach to investigating and addressing causes of maternal deaths in Zambia’s Copperbelt
Background: Maternal mortality in developing countries is high and international targets for reduction are unlikely to be met. Zambia’s maternal mortality ratio was 591 per 100,000 live births according to survey data (2007) while routinely collected data captured only about 10% of these deaths. In one district in Zambia medical staff reviewed deaths occurring in […]
