Maternal and neonatal survival and mortality in the Upper West Region of Ghana

Issah, Kofi; Nang-Beifubah, Alexis; Opoku, Chris F.

doi:10.1016/j.ijgo.2011.01.007

Cited by 25 publications

(35 citation statements)

References 3 publications

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“…Of note, the four datasets from India were obtained from the same investigation [24]. The oldest dataset was from 1967 [24] and the most recent datasets were from 2009 [47, 62]. Thirty-one of the 44 datasets (70.5%) examined maternal deaths while the other 13 datasets (29.5%) examined perinatal deaths.…”

Section: Resultsmentioning

confidence: 99%

Audit-identified avoidable factors in maternal and perinatal deaths in low resource settings: a systematic review

Merali

Lipsitz

Hevelone

et al. 2014

BMC Pregnancy Childbirth

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BackgroundAudits provide a rational framework for quality improvement by systematically assessing clinical practices against accepted standards with the aim to develop recommendations and interventions that target modifiable deficiencies in care. Most childbirth-associated mortality audits in developing countries are focused on a single facility and, up to now, the avoidable factors in maternal and perinatal deaths cataloged in these reports have not been pooled and analyzed. We sought to identity the most frequent avoidable factors in childbirth-related deaths globally through a systematic review of all published mortality audits in low and lower-middle income countries.MethodsWe performed a systematic review of published literature from 1965 to November 2011 in Pubmed, Embase, CINAHL, POPLINE, LILACS and African Index Medicus. Inclusion criteria were audits from low and lower-middle income countries that identified at least one avoidable factor in maternal or perinatal mortality. Each study included in the analysis was assigned a quality score using a previously published instrument. A meta-analysis was performed for each avoidable factor taking into account the sample sizes and quality score from each individual audit. The study was conducted and reported according to PRISMA guidelines for systematic reviews.ResultsThirty-nine studies comprising 44 datasets and a total of 6,205 audited deaths met inclusion criteria. The analysis yielded 42 different avoidable factors, which fell into four categories: health worker-oriented factors, patient-oriented factors, transport/referral factors, and administrative/supply factors. The top three factors by attributable deaths were substandard care by a health worker, patient delay, and deficiencies in blood transfusion capacity (accounting for 688, 665, and 634 deaths attributable, respectively). Health worker-oriented factors accounted for two-thirds of the avoidable factors identified.ConclusionsAudits provide insight into where systematic deficiencies in clinical care occur and can therefore provide crucial direction for the targeting of interventions to mitigate or eliminate health system failures. Given that the main causes of maternal and perinatal deaths are generally consistent across low resource settings, the specific avoidable factors identified in this review can help to inform the rational design of health systems with the aim of achieving continued progress towards Millennium Development Goals Four and Five.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2393-14-280) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Audit-identified avoidable factors in maternal and perinatal deaths in low resource settings: a systematic review

Merali

Lipsitz

Hevelone

et al. 2014

BMC Pregnancy Childbirth

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“…A terceira demora é a que ocorre relacionada à qualidade da atenção na unidade de saúde em que medidas específicas, se não tomadas em momento oportuno, também podem ser a causa de desfechos não satisfatórios 14 . Embora o presente estudo não tenha especificamente investigado demoras, os achados potencialmente relacionados às demoras são similares a outros que abordam o mesmo tema 15,16 . Nesta série de casos predominaram causas obstétricas de óbito materno, o que geralmente ocorre na análise de dados de populações de países em desenvolvimento 17 e que se associa a deficiências na condução de casos, com possibilidade de reversão se atendidos de forma correta no momento ideal.…”

Section: Discussionunclassified

Mortalidade materna em um centro de referência do Sudeste Brasileiro

Troncon¹,

Netto²,

Rehder³

et al. 2013

Rev. Bras. Ginecol. Obstet.

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ResumoOBJETIVO: Descrever a frequência da mortalidade materna em um hospital de atendimento terciário e avaliar a sua evitabilidade. MÉTODOS: O presente estudo, mediante a análise das mortes maternas ocorridas no período de 1999 a 2010 em uma maternidade de referência de Campinas -Brasil, aborda alguns dos fatores associados, as principais causas de óbito e alguns problemas de estrutura dos serviços de saúde. É um estudo descritivo retrospectivo com avaliação de variáveis sociodemográficas, história clínica e obstétrica das mulheres, além das causas do óbito. RESULTADOS: A maioria dos óbitos maternos ocorreu por causas obstétricas diretas (45%) e evitáveis (36%), em mulheres com gestação pré-termo que tiveram o parto por cesárea (56%) e vários procedimentos de manejo, incluindo transfusão sanguínea, admissão em UTI e necessidade de laparotomia e/ou histerectomia. A transferência de outro hospital esteve associada ao predomínio de causas obstétricas diretas (19 versus 6, p=0,02) e evitáveis (22 versus 9, p=0,01). CONCLUSÃO: A mortalidade materna por causas infecciosas e hipertensivas ainda predomina. Observamos o aumento de causas clínico-cirúrgicas e neoplásicas como causa do óbito em mulheres durante o ciclo grávido puerperal. Abstract PURPOSE:To describe the prevalence of maternal mortality at a tertiary care hospital and to assessits preventability. METHODS: This study, through the analysis of maternal deaths that occurred during the period from 1999 to 2010 at a reference in Campinas -Brazil, CAISM/ UNICAMP, discusses some of the factors associated with the main causes of death and some structural problems of structure of the health services. It is a retrospective descriptive study with evaluation of sociodemographic variables and the medical and obstetric history of women, and the causes of death. RESULTS: The majority of maternal deaths occurred due to direct obstetric (45%) and avoidable (36%) causes, in women with preterm gestation, who delivered by cesarean section (56%) and received various management procedures, including blood transfusion, ICU admission and need for laparotomy and/or hysterectomy. The hospital transfer was associated with the predominance of direct obstetric (19 versus 6, p=0.02) and avoidable causes (22 versus 9, p=0.01). CONCLUSIONS: We conclude that, despite current advances in Obstetrics, infections and hypertensive disorders are still the predominant causes of maternal mortality. We observed an increase of clinical-surgical conditions and neoplasms as causes of death among women during pregnancy.

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“…However, a combination of these factors is required for women to have a final say about issues pertaining to their healthcare utilisation [13, 14]. At the same time, it has been noted that low empowerment status curtails women's ability to access healthcare; for instance, an assessment of participation in Community-based Health Planning and Services (CHPS) in Ghana indicated that male dominance and limited women's access to services are rendered by the CHPS compounds [15].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have reported inconsistent effects of women's decision-making autonomy on the use of health services [11, 13–15]. This may be due to the fact that virtually all the existing studies aggregate three autonomy variables—control over finance, decision-making power, and extent of freedom of movement.…”

Section: Introductionmentioning

confidence: 99%

Women’s Health Decision-Making Autonomy and Skilled Birth Attendance in Ghana

Ameyaw

Tanle

Kissah-Korsah

et al. 2016

International Journal of Reproductive Medicine

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Delivering in health facility under the supervision of skilled birth attendant is an important way of mitigating impacts of delivery complications. Empirical evidence suggests that decision-making autonomy is aligned with holistic wellbeing especially in the aspect of maternal and child health. The objective of this paper was to examine the relationship between women's health decision-making autonomy and place of delivery in Ghana. We extracted data from the 2014 Ghana Demographic and Health Survey. Descriptive and logistic regression techniques were applied. The results indicated that women with health decision-making autonomy have higher tendency of health facility delivery as compared to those who are not autonomous [OR = 1.27, CI = 1.09–1.48]. However, those who have final say on household large purchases [OR = 0.71, CI = 0.59–0.84] and those having final say on visits [OR = 0.86, CI = 0.73–1.01] were less probable to deliver in health facility than those without such decision-making autonomy. Consistent with existing evidence, wealthier, urban, and highly educated women had higher inclination of health facility delivery. This study has stressed the need for interventions aimed at enhancing health facility delivery to target women without health decision-making autonomy and women with low education and wealth status, as this can play essential role in enhancing health facility delivery.

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Maternal and neonatal survival and mortality in the Upper West Region of Ghana

Abstract: Maternal death notifications and audits are useful tools for improving quality of care and outcomes. With almost half of maternal deaths occurring within 24 hours of admission, emergency care in the Upper West Region of Ghana must be improved.

Cited by 25 publications

References 3 publications

Audit-identified avoidable factors in maternal and perinatal deaths in low resource settings: a systematic review

Audit-identified avoidable factors in maternal and perinatal deaths in low resource settings: a systematic review

Mortalidade materna em um centro de referência do Sudeste Brasileiro

Women’s Health Decision-Making Autonomy and Skilled Birth Attendance in Ghana

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