From MDGs to SDGs: implications for maternal newborn health in Africa

No Abstrac

Exchanging ideas and good practice globally: reciprocal learning in the context of a twinning project

Between August and November 2019, I had the pleasure of making two trips to Bangladesh to support the Royal College of Midwives’ (RCM) twinning project with the Bangladesh Midwifery Society (BMS). The partnership between the RCM and the BMS aims to strengthen the BMS to advocate for the midwifery profession and to create demand for midwifery services. The project is part of a wider programme of midwifery strengthening activities, managed by the United Nations Population Fund (UNFPA) Bangladesh, and funded by donors, the Department for International Development (DFID) and the Swedish International Development Cooperation Agency (Sida)

Social determinants and maternal exposure to intimate partner violence of obstetric patients with severe maternal morbidity in the intensive care unit: a systematic review protocol

Introduction: Maternal mortality is a potentially preventable public health issue. Maternal morbidity is increasingly of interest to aid the reduction of maternal mortality. Obstetric patients admitted to the intensive care unit (ICU) are an important part of the global burden of maternal morbidity. Social determinants influence health outcomes of pregnant women. Additionally, intimate partner violence has a great negative impact on women's health and pregnancy outcome. However, little is known about the contextual and social aspects of obstetric patients treated in the ICU. This study aimed to conduct a systematic review of the social determinants and exposure to intimate partner violence of obstetric patients admitted to an ICU. Methods and analysis: A systematic search will be conducted in MEDLINE, CINAHL, ProQuest, LILACS and SciELO from 2000 to 2016. Studies published in English and Spanish will be identified in relation to data reporting on social determinants of health and/or exposure to intimate partner violence of obstetric women, treated in the ICU during pregnancy, childbirth or within 42 days of the end of pregnancy. Two reviewers will independently screen for study eligibility and data extraction. Risk of bias and assessment of the quality of the included studies will be performed by using the Critical Appraisal Skills Programme (CASP) checklist. Data will be analysed and summarised using a narrative description of the available evidence across studies. This systematic review protocol will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. Ethics and dissemination: Since this systematic review will be based on published studies, ethical approval is not required. Findings will be presented at La Trobe University, in Conferences and Congresses, and published in a peer-reviewed journal

Causes of Maternal Mortality in Tehran, Iran

Maternal mortality is a woman’s death during pregnancy or postpartum period due to direct or indirect causes. Its direct causes are related to obstetrical issues. The indirect cause of it refer to an underlying disease, i.e. aggravated during pregnancy and leads to death. A routine data-based study conducted at the Legal Medicine Organization of Tehran City, Iran, the autopsy findings of maternal mortalities during April 2017-2019 were reviewed. During the study period, 53 cases were autopsied of which 29 (54.7%) and 24 (45.3%) died due to direct and indirect causes, respectively. , The prevalent direct causes of death, were bleeding (22.6%), eclampsia/preeclampsia (13.2%), and ectopic pregnancy (5.7%). Frequent indirect causes were cardiac diseases (20.7%) and nervous system and infectious diseases (both: 7.5%). This study revealed the considerable share of indirect causes in maternal mortalities in Tehran. Moreover, we outlined the importance of early detection of non-obstetrical medical conditions during pregnancy care to reduce preventable maternal mortalities

A study of different contraceptive methods: need of the hour during COVID 19 pandemic

Background: COVID-19 disease is the pandemic caused by a single-stranded RNA virus that belongs to the coronavirus family known as 2019-nCoV (SARS-Co V). The disease is highly contagious and transmitted mainly by droplets or close contact. In this time of pandemic it is need of the hour to prevent more and more unwanted pregnancies. This study was to evaluate the contraceptive methods of choice which are easily available, cost effective and suitable to most of the patients during this terrible period of pandemic.Methods: This was a prospective observational study done from April 2020 to December 2020. Women coming to the OPD for contraceptive advice after medical termination of pregnancy and patients desiring postpartum contraception were included in the study. All data were collected from the OPD and IPD of our hospital. Different contraceptive methods available, their costs, hospital visits, complications, failure rate and reason for its discontinuation was analysed.Results: In this study 76.5% patients (n-459) accepted Inj. DMPA as compared to 10 % used Cu T and 13% used OC pills as a method of contraception. Inj DMPA is easily available, cost effective, has lesser side effects and need less hospital visits.Conclusions: DMPA should be made available as a first line method to all those who wishes to opt for reversible method of contraception. This study concludes, during the period of pandemic Inj DMPA was most preferred method of contraception

Twenty five years fighting for women's health and rights : some progress but still a long way to go

The aim of this paper is to provide an overview of 25 years women’s health and rights, a difficult journey with steps forward and backwards since the landmark conference in 1994 when reproductive rights were for the first time on the menu. However, although great strides have been made in reducing maternal and child mortality since then, among others by the United Nations with the establishment of the Millennium Development Goals for 2015, showing that change is possible, many countries are still lagging behind in reaching the goals. While the new global architecture, in particular with the Sustainable Development Goals and the Global Strategy for Women’s, Children’s and Adolescents’ Health, ensures that these issues remain high on the political agenda, this paper argues that we must move from political commitment to action, via the creation and dissemination of research evidence. As the Founding President of the Ghent Africa Platform (GAP) at Ghent University, I still believe GAP has an important role to play regarding this international collaboration and dissemination of scientific knowledge

Changing trends of maternal mortality with its causes- ten years retrospective study in a peripheral medical college of West Bengal, India

Background: The estimates of maternal mortality can only be used as a rough indicator of maternal health situation in any given country. High maternal mortality reflects not only in inadequacy of health care services for mothers, but also a low standard of living and socio economic status of the community. Objective was to assess the maternal mortality ratio (MMR), its probable causes and changing trends.Methods: The present study conducted at Midnapore Medical College (MMC), West Bengal. Data for analysis were collected from medical college record section and maternal death registrar book after having permission from higher authority of the college during the period from January 2009 to 2018 December. Total sample size for this period was 249. Statistical analysis was done through SPSS software.Results: Ten years data analysis of 249 subjects showed that total live births from January 2009 to December 2018 was 1,39,126 with MMR 178.97%. Hypertensive disorder of pregnancy (40.56%) was the leading direct cause of maternal death followed by hemorrhage (24.49%) and septicemia (10.84%). Heart disease (6.42%) was the major indirect cause of death followed by anemia (3.6%). Maternal death rate found high among primi gravida (59.43%) mothers and within 20 years age group (46.18%).Conclusions: Most maternal deaths are preventable by proper antenatal care, early diagnosis of high risk factors, timely referral to tertiary care centre along with community upliftment especially in rural and tribal based population.

Analysis of maternal mortality at tertiary care centre

Background: The aim of the study was to analyse the causes of maternal mortality at a tertiary care centre and find measures to reduce it.Methods: A retrospective study of maternal deaths from January 2018 to December 2020 that occurred at Government Vellore Medical College and Hospital, a tertiary care hospital in Tamil Nadu. Data collected from case records and death reviews.Results: There was total of 71 deaths at the tertiary care hospital during the period January 2018 to December 2020 out of 31407 live births giving Maternal mortality rate of 226/1,00,000 live births. The MMR is high as it is a tertiary hospital catering referral from six districts. Most of the cases were due to late referrals. The majority of the deaths occurred in primigravida (50.7%), in the age group of 21 to 25 years (35.2%) and around term gestational age (49.3%). The most common cause of death in our study was hypertensive disorders of pregnancy (29.5%) followed by PPH (14.08%).Conclusions: From our study we concluded that the most common causes of maternal death were due to direct obstetric causes like severe pre-eclampsia, eclampsia and post-partum haemorrhage. Early identification of high-risk cases, early identification of GHT, anaemia and its correction, early referral of high-risk cases to tertiary centre can prevent most of the deaths.

Labour and Delivery Practices in Selected Primary Health Centres in Jos Metropolis, Plateau State

Every labour and child delivery activity comes with a collateral vicissitude hence the need to be accurate in its handling toward producing positive outcome. This concern has immensely drawn the attention of the global stakeholders which found its expression in Sustainable Goal Development three (Target 1) aimed at reducing the maternal mortality globally. This study was necessitated by the fact that the level of maternal mortality in Nigeria is unacceptable which invariably makes a lot of practitioners and researchers uncomfortable hence the need to further make an inquiry into how delivery and labour activities are conducted. Evidence abounds that the maternal mortality rate in Jos follows the pattern of that of the nation as a whole. The study was carried out in the selected primary health centres within the two main local government areas that constitute Jos metropolis. The setting of the study was picked as it functions as the operational level of primary health care. The level of care sophistication is relatively low in this setting. The study adopted a descriptive, cross sectional and non-experimental research design. The study population comprised nurses and community health workers working in those primary health centres. Multisampling technique was used in selecting the health centres used in the study. The sample size was one hundred and thirty-five. Convenience sampling technique was adopted in accessing the respondents. A total of one hundred and thirty-three inclined thereby creating a response rate of 98.5%. The ethical injunctions guiding research were observed as the respondents’ informed consent was sought. Assurance was given in the aspects of confidentiality and anonymity. The right to withdraw clause was also emphasized. Data was analyzed using percentages and frequency counts. Results reveal the techniques embedded in labour and delivery as these include assessment of patient’s psychological readiness and foetal readiness for continuous maternal support; and use of partograph. Further, results indicate lack of adequately trained health workers, lack of cordial relationships between mothers and health personnel, inadequate facilities, and financial strain as the factors that affect labour and delivery practices in primary health centres in Jos Metropolis. The import of the findings is that efforts should be strengthened toward upgrading the skills of the health workers, and making adequate provision for needed resources. Keywords: Labour, Delivery, Practices, Primary Health Centres DOI: 10.7176/JHMN/102-04 Publication date:September 30th 202