Inequities in resources and preparedness for surgical complications of caesarean section in southern Gauteng hospitals

Maswime, Salome; Buchmann, Eckhart

doi:10.7196/sajog.1039

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…[9] This is not the case in our hospital and many SA hospitals with staff shortages. Maswime and Buchmann [10] described the inequities between regional and district hospitals in Johannesburg, with regional hospitals having 2.7 specialists per 10 000 births v. 11.8/10 000 births in tertiary hospitals. The MMR in regional hospitals was 204/100 000 compared…”

Section: Discussionmentioning

confidence: 99%

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Causes of maternal death at Natalspruit Hospital, Johannesburg, South Africa

Uzabakiriho

Maswime

2019

S Afr Med J

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According to the World Health Organization (WHO), 800 women die per day globally owing to pregnancy-related complications. The lifetime risk of a woman dying from a pregnancy-related cause in a low-income country is 25 times higher than in a high-income country. High-income countries have a much lower mortality rate than low-income countries. [1] Since the inception of the National Committee on the Confidential Enquiries into Maternal Deaths in October 1997, maternal mortality has been the main indicator used to measure the quality of care in South Africa (SA). [2] Despite the increase in resources countrywide to prevent maternal mortality, SA nevertheless has a highly unacceptable maternal mortality rate (MMR). The MMR is 127/100 000 in developing countries compared with 16/100 000 in developed countries. [3] SA had an institutional MMR (iMMR) of 154/100 000 in the 2011-2013 Saving Mothers Report. [4] A review of maternal deaths in SA shows an increasing number of deaths between 1999 and 2010. [2] Ekurhuleni District was among the poorly performing districts in SA. The aim of the study was to assess the causes of maternal deaths at Natalspruit Hospital, Johannesburg, SA, and to make recommendations to improve the quality of care. This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

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Section: Discussionmentioning

confidence: 99%

“…Advocacy for optimal training by universities was considered to be one of the reasons for better staffing and better outcomes in teaching hospitals. [10] Study strengths and limitations…”

Section: Researchmentioning

confidence: 99%

Causes of maternal death at Natalspruit Hospital, Johannesburg, South Africa

Uzabakiriho

Maswime

2019

S Afr Med J

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“…Barriers related to knowledge and skills were the most prominent theme under the providers of care domain. The main barriers identified included inadequate training on current evidence-based treatment [33][34][35][36][37][38][39][40] , an insufficient number of skilled healthcare workers [41][42][43][44][45] , and inadequate providers' knowledge of disease management [46][47][48] .…”

Section: Knowledge and Skillsmentioning

confidence: 99%

Implementing essential diagnostics-learning from essential medicines: A scoping review

Nyanchoka

Mulaku

Nyagol

et al. 2022

Preprint

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Background The World Health Organization (WHO) model list of Essential In vitro Diagnostic (EDL) introduced in 2018 complements the established Essential Medicines List (EML) and improves its impact on advancing universal health coverage and better health outcomes. We conducted a scoping review of the literature on the implementation of the WHO essential lists in Africa to inform the implementation of the recently introduced EDL. Methods We searched eight electronic databases for studies reporting on the implementation of the WHO EDL and EML in Africa. Two authors independently conducted study selection and data extraction, with disagreements resolved through discussion. We used the Supporting the Use of Research Evidence (SURE) framework to extract themes and synthesized findings using thematic content analysis. We used the Mixed Method Appraisal Tool (MMAT) version 2018 to assess the quality of included studies where applicable. Results We included 172 studies reporting on EDL and EML after screening 3,813 articles titles and abstracts and 1,545 full-text papers. Most (75%, n=129) included studies were purely quantitative in design comprising descriptive cross-sectional designs (60%, n=104), 15% (n=26) were purely qualitative, and 10% (n=17) had mixed-methods approaches. There were no qualitative or randomised experimental studies about the EDL. The main barrier facing the EML and EDL was poorly equipped health facilities - including unavailability or stock-outs of essential in vitro diagnostics and medicines and inadequate infrastructure to enable health service delivery. Financial and non-financial incentives to health facilities and workers were a key enabler to the implementation of the EML however, their impact differed from one context to another. Fifty-six (33%) of the included studies were of high quality. Conclusions The EDL implementation at the national level can learn from health system interventions to improve the availability and supply of essential medicines such as financial and non-financial incentives in different contexts.

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“…training on current evidence-based treatment [71,[116][117][118][119], an insufficient number of skilled healthcare workers [105,112,[120][121][122], and inadequate providers' knowledge of disease management [50,83,123]. Other barriers included lack of knowledge of inventory management PLOS GLOBAL PUBLIC HEALTH [124,125], lack of awareness of available guidelines [52], and poor understanding of partner programmes [106,126].…”

Section: Plos Global Public Healthmentioning

confidence: 99%

Implementing essential diagnostics-learning from essential medicines: A scoping review

Nyanchoka

Mulaku²,

Nyagol³

et al. 2022

PLOS Glob Public Health

View full text Add to dashboard Cite

The World Health Organization (WHO) model list of Essential In vitro Diagnostic (EDL) introduced in 2018 complements the established Essential Medicines List (EML) and improves its impact on advancing universal health coverage and better health outcomes. We conducted a scoping review of the literature on implementing the WHO essential lists in Africa to inform the implementation of the recently introduced EDL. We searched eight electronic databases for studies reporting on implementing the WHO EDL and EML in Africa. Two authors independently conducted study selection and data extraction, with disagreements resolved through discussion. We used the Supporting the Use of Research Evidence (SURE) framework to extract themes and synthesised findings using thematic content analysis. We used the Mixed Method Appraisal Tool (MMAT) version 2018 to assess the quality of included studies. We included 172 studies reporting on EDL and EML after screening 3,813 articles titles and abstracts and 1,545 full-text papers. Most (75%, n = 129) studies were purely quantitative in design, comprising descriptive cross-sectional designs (60%, n = 104), 15% (n = 26) were purely qualitative, and 10% (n = 17) had mixed-methods approaches. There were no qualitative or randomised experimental studies about EDL. The main barrier facing the EML and EDL was poorly equipped health facilities—including unavailability or stock-outs of essential in vitro diagnostics and medicines. Financial and non-financial incentives to health facilities and workers were key enablers in implementing the EML; however, their impact differed from one context to another. Only fifty-six (33%) of the included studies were of high quality. Poorly equipped and stocked health facilities remain an implementation barrier to essential diagnostics and medicines. Health system interventions such as financial and non-financial incentives to improve their availability can be applied in different contexts. More implementation study designs, such as experimental and qualitative studies, are required to evaluate the effectiveness of essential lists.

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Inequities in resources and preparedness for surgical complications of caesarean section in southern Gauteng hospitals

Cited by 4 publications

References 9 publications

Causes of maternal death at Natalspruit Hospital, Johannesburg, South Africa

Causes of maternal death at Natalspruit Hospital, Johannesburg, South Africa

Implementing essential diagnostics-learning from essential medicines: A scoping review

Implementing essential diagnostics-learning from essential medicines: A scoping review

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