Antenatal care in Maputo, Mozambique.

Jelley, Diana; Madeley, Richard

doi:10.1136/jech.37.2.111

Cited by 13 publications

(4 citation statements)

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“…One study in three clinics in Maputo, Mozambique (one each urban, peri‐urban and rural) found that, although many women were successfully assessed, referred and cared for, less than half of those in the high‐risk group were actually seen at the referral centre. Furthermore, only 11% of women referred from the rural clinic for delivery in hospital actually delivered there, compared with 66% of those referred from the other two clinics 61 . Distance appeared to be a stronger determinant of place of delivery than risk screening.…”

Section: Antenatal Care Programmesmentioning

confidence: 84%

How effective is antenatal care in preventing maternal mortality and serious morbidity? An overview of the evidence

Carroli

Rooney

Villar

2001

Paediatric Perinatal Epid

391

259

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This is an overview of evidence of the effectiveness of antenatal care in relation to maternal mortality and serious morbidity, focused in particular on developing countries. It concentrates on the major causes of maternal mortality, and traces their antecedent morbidities and risk factors in pregnancy. It also includes interventions aimed at preventing, detecting or treating any stage along this pathway during pregnancy. This is an updated and expanded version of a review first published by the World Health Organization (WHO) in 1992. The scientific evidence from randomised controlled trials and other types of intervention or observational study on the effectiveness of these interventions is reviewed critically. The sources and quality of available data, and possible biases in their collection or interpretation are considered. As in other areas of maternal health, good-quality evidence is scarce and, just as in many aspects of health care generally, there are interventions in current practice that have not been subjected to rigorous evaluation. A table of antenatal interventions of proven effectiveness in conditions that can lead to maternal mortality or serious morbidity is presented. Interventions for which there is some promising evidence, short of proof, of effectiveness are explored, and the outstanding questions formulated. These are presented in a series of tables with suggestions about the types of study needed to answer them.

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Section: Antenatal Care Programmesmentioning

confidence: 84%

How effective is antenatal care in preventing maternal mortality and serious morbidity? An overview of the evidence

Carroli

Rooney

Villar

2001

Paediatric Perinatal Epid

391

259

View full text Add to dashboard Cite

show abstract

“…1,9,14 Noncompliance with recommendation for hospital delivery sometimes involved nurse-midwives not recommending hospital delivery for at-risk women. 9,14 Other reasons for out-of-hospital delivery among high-risk women include the onset of a rapid labour at home, preterm labour and lack of transport, as well as lack of confidence in maternity services. 2,15 Some at-risk women are recommended hospital delivery without adequate explanation of the perceived risk and no practical arrangements for hospital transfer in labour.…”

Section: Discussionmentioning

confidence: 99%

“…The fact that some women deliberately avoid health facility delivery because of staff attitudes is cause for concern and has been reported from the subregion. 1,3,14 The low recurrence ratio for most complications limits interventions for specific risk factors. There is, however, need to acknowledge that there are no effective interventions for some identified risks such as preterm delivery.…”

Section: Discussionmentioning

confidence: 99%

Does maternity care improve pregnancy outcomes in women with previous complications? A study from Zimbabwe

et al. 2005

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To determine the utilization of maternal health care services and pregnancy outcomes for women with a history of complications in previous pregnancy, we analysed the pregnancy records of multiparous women (parity > or =1) who booked and completed follow-up in Gutu district, Zimbabwe between January 1995 and June 1998. Women with previous uncomplicated pregnancies (n = 6140) were classified as low risk, whereas those with complications of previous pregnancy (n = 1077) were classified high risk. At enrolment, there was no difference in maternal age and parity between low- and high-risk women. A higher proportion of high-risk women had more than five antenatal visits (32% versus 21%; P<0.001) and gave birth in hospital (47% versus 18%; P<0.001). The risk of antenatal (relative risk [RR] 1.57; 95% confidence interval [CI] 1.32-1.88), labour/delivery (RR 1.98; 95% CI 1.75-2.25) and neonatal (RR 1.83; 95% CI 1.44-2.34) complications was elevated in high-risk women. There was increased risk for perinatal death in high-risk women, but this did not reach statistical significance (RR 1.56; 95% CI 0.98-2.49). The recurrence ratio for most complications was low and the sensitivity of historical risk markers in predicting women likely to develop further complicated pregnancies was only 23%. Most women with previous pregnancy complications can safely give birth in the rural health centre. We concluded that high-risk women had an elevated risk of complications in the index pregnancy and that better utilization of maternal health care, especially for delivery, reduced adverse perinatal outcomes.

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“…This "agency-less" model of illness causality may be in keeping with public health models that assume pathogens do not have a "mind of their own." However, evidence suggests that inherent biological risks are not the threats most salient to women at whom SMI is directed (Chapman 2003;Jelley 1983aJelley , 1983bNdyomugyenyi et al 1998;Sargent and Rawlins 1991;White 2002). In the Mozambican example, the primary and most feared cause of sickness as one kind of misfortune among many, is other people who purposefully make others suffer through witchcraft or sorcery.…”

Section: Layers Of Reproductive Vulnerability In Mozambiquementioning

confidence: 99%

Chikotsa—Secrets, Silence, and Hiding: Social Risk and Reproductive Vulnerability in Central Mozambique

Chapman

2006

Med Anthropol Q

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In this article, I examine pregnancy narratives and patterns of reproductive health seeking among women of fertile age in central Mozambique. I map the interplay between gendered economic marginalization, maternal risk perceptions, and pregnancy management strategies. By interpreting my data in light of Shona illness theories, I illuminate the ways that embodied experiences of reproductive vulnerability, risk perceptions, and social inequalities are linked: women attribute the most serious maternal complications to human- or spirit-induced reproductive threats of witchcraft and sorcery. This construction of reproductive vulnerability as social threats related to material and social competition significantly influences prenatal health seeking. Data reveal the structural and cognitive gap between biomedical constructions of risk and lay social threat perceptions. Plural health care systems are strategically utilized by women seeking to minimize both social and biological harm. On-the-ground ethnography shows that maternal health initiatives must take this plurality into full and accommodative account to achieve viable improvements in reproductive care and outcomes.

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Antenatal care in Maputo, Mozambique.

Cited by 13 publications

References 0 publications

How effective is antenatal care in preventing maternal mortality and serious morbidity? An overview of the evidence

How effective is antenatal care in preventing maternal mortality and serious morbidity? An overview of the evidence

Does maternity care improve pregnancy outcomes in women with previous complications? A study from Zimbabwe

Chikotsa—Secrets, Silence, and Hiding: Social Risk and Reproductive Vulnerability in Central Mozambique

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