Antenatal care and skilled birth in the fragile and conflict‐affected situation of Burundi

Ziegler, Bianca R; Kansanga, Moses Mosonsieyiri; Sano, Yuji; Kangmennaang, Joseph; Kpienbaareh, Daniel; Luginaah, Isaac

doi:10.1002/hpm.3157

Cited by 3 publications

(1 citation statement)

References 25 publications

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“…Other published studies in DRC, Nigeria, and Burundi have found similar evidence, wherein fragile areas not directly affected by conflict may have maternal health indicators that are similar to or worse than those in conflict-affected areas in the same country. Their authors concluded that this phenomenon was likely due to minimal international support and investments in fragile areas [4,47,[61][62][63][64][65] compared with the settings experiencing acute conflict.…”

Section: Discussionmentioning

confidence: 99%

High severity of abortion complications in fragile and conflict-affected settings: A cross-sectional study in two referral hospitals in Sub-Saharan Africa (AMoCo study)

Pasquier

Owolabi

Fetters³

et al. 2022

Preprint

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Background: Abortion-related complications are one of the five main causes of maternal mortality. However, research about abortion is very limited in fragile and conflict-affected settings. Our study aims to describe the magnitude and severity of abortion-related complications in two referral hospitals located in such settings in northern Nigeria and Central African Republic (CAR).Methods: We used a methodology similar to the World Health Organization (WHO) near-miss approach adapted in the WHO multi-country study on abortion (WHO-MCS-A). We conducted a cross-sectional study using prospective medical record review of women presenting with abortion-related complications between November 2019 and July 2021. We used descriptive analysis and categorized complications into four mutually exclusive categories of increasing severity.Results: We analyzed data from 520 women in Nigeria and 548 women in CAR. Abortion complications represented 4.2% (Nigeria) and 19.9% (CAR) of all pregnancy-related admissions. The severity of abortion complications was high: 103 (19.8%) and 34 (6.2%) women were classified as having severe maternal outcomes (near-miss cases and deaths), 245 (47.1%) and 244 (44.5%) potentially life-threatening, 39 (7.5%) and 93 (17.0%) moderate, and 133 (25.6%) and 177 (32.3%) mild complications, respectively in Nigeria and CAR. Severe bleeding/hemorrhage was the main type of complication in both settings (71.9%in Nigeria, 57.8% in CAR), followed by infection (18.7% in Nigeria, 27.0% in CAR). Among the 146 women (Nigeria) and 231 women (CAR) who did not report severe bleeding or hemorrhage before or during admission, anemia was more frequent in Nigeria (66.7%) compared to CAR (37.6%).Conclusion: Our data suggests greater severity of abortion-related complications compared with the 210 African referral facilities of a recent WHO study in more stable settings. Factors that could contribute to this greater severity in these contexts include greater delays in accessing post-abortion care, decreased access to contraceptive and safe abortion care that result in increased unsafe induced abortions; as well as increased food insecurity leading to iron-deficiencies and chronic anaemia. The results highlight the need for better access to safe abortion care, contraception, and high quality postabortion care to prevent and manage complications of abortions in fragile and conflict-affected settings.

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Section: Discussionmentioning

confidence: 99%

High severity of abortion complications in fragile and conflict-affected settings: A cross-sectional study in two referral hospitals in Sub-Saharan Africa (AMoCo study)

Pasquier

Owolabi

Fetters³

et al. 2022

Preprint

View full text Add to dashboard Cite

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Antenatal care utilization and its determinants in fragile and conflict-affected situations in Sekota Zuria District, Northern Ethiopia, 2022: A community-based cross-sectional study

Gedef,

Girma,

Andualem

et al. 2024

Midwifery

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High severity of abortion complications in fragile and conflict-affected settings: a cross-sectional study in two referral hospitals in sub-Saharan Africa (AMoCo study)

Pasquier

Owolabi

Fetters³

et al. 2023

BMC Pregnancy Childbirth

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Background Abortion-related complications are one of the five main causes of maternal mortality. However, research about abortion is very limited in fragile and conflict-affected settings. Our study aims to describe the magnitude and severity of abortion-related complications in two referral hospitals supported by Médecins Sans Frontières and located in such settings in northern Nigeria and Central African Republic (CAR). Methods We used a methodology similar to the World Health Organization (WHO) near-miss approach adapted in the WHO multi-country study on abortion (WHO-MCS-A). We conducted a cross-sectional study in the two hospitals providing comprehensive emergency obstetric care. We used prospective medical records’ reviews of women presenting with abortion-related complications between November 2019 and July 2021. We used descriptive analysis and categorized complications into four mutually exclusive categories of increasing severity. Results We analyzed data from 520 and 548 women respectively in Nigerian and CAR hospitals. Abortion complications represented 4.2% (Nigerian hospital) and 19.9% (CAR hospital) of all pregnancy-related admissions. The severity of abortion complications was high: 103 (19.8%) and 34 (6.2%) women were classified as having severe maternal outcomes (near-miss cases and deaths), 245 (47.1%) and 244 (44.5%) potentially life-threatening, 39 (7.5%) and 93 (17.0%) moderate, and 133 (25.6%) and 177 (32.3%) mild complications, respectively in Nigerian and CAR hospitals. Severe bleeding/hemorrhage was the main type of complication in both settings (71.9% in the Nigerian hospital, 57.8% in the CAR hospital), followed by infection (18.7% in the Nigerian hospital, 27.0% in the CAR hospital). Among the 146 women (Nigerian hospital) and 231 women (CAR hospital) who did not report severe bleeding or hemorrhage before or during admission, anemia was more frequent in the Nigerian hospital (66.7%) compared to the CAR hospital (37.6%). Conclusion Our data suggests high severity of abortion-related complications in these two referral facilities of fragile and conflict-affected settings. Factors that could contribute to this high severity in these contexts include greater delays in accessing post-abortion care, decreased access to contraceptive and safe abortion care that result in increased unsafe abortions; as well as increased food insecurity leading to iron-deficiencies and chronic anaemia. The results highlight the need for better access to safe abortion care, contraception, and high quality postabortion care to prevent and manage complications of abortion in fragile and conflict-affected settings.

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Antenatal care and skilled birth in the fragile and conflict‐affected situation of Burundi

Cited by 3 publications

References 25 publications

High severity of abortion complications in fragile and conflict-affected settings: A cross-sectional study in two referral hospitals in Sub-Saharan Africa (AMoCo study)

High severity of abortion complications in fragile and conflict-affected settings: A cross-sectional study in two referral hospitals in Sub-Saharan Africa (AMoCo study)

Antenatal care utilization and its determinants in fragile and conflict-affected situations in Sekota Zuria District, Northern Ethiopia, 2022: A community-based cross-sectional study

High severity of abortion complications in fragile and conflict-affected settings: a cross-sectional study in two referral hospitals in sub-Saharan Africa (AMoCo study)

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