Maternal morbidity during labour and the puerperium in rural homes and the need for medical attention: A prospective observational study in Gadchiroli, India

Bang, Rani A; Bang, Abhay; Reddy, Maya; Deshmukh, Mahesh; Baitule, Sanjay B; Filippi, Véronique

doi:10.1111/j.1471-0528.2004.00063.x

Cited by 106 publications

(124 citation statements)

References 16 publications

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“…Table 1 summarizes the demographic profile of all women in the study. Similar profile was demonstrated in other Indian studies by Bang et al and Khosla et al [6,7]. 65.38 % of women belonged to rural areas and of lower socioeconomic status (grade IV and V).…”

Section: Discussionsupporting

confidence: 85%

Obstetric Emergencies: Role of Obstetric Drill for a Better Maternal Outcome

Singh

Nandi

2012

J Obstet Gynecol India

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Objective To evaluate factors contributing to obstetric emergencies, analyze the fetomaternal outcome and role of obstetric drill in facing these emergencies effectively. Material and Method Out of 10,892 deliveries, a total of 520 women were included in this prospective study. Analysis of emergency obstetric conditions was done by evaluating incidence, various contributing factors, and fetomaternal outcome. Obstetric drill was conducted among residents repetitively. Pre drill and post drill assessment of confidence in clinical, knowledge, and team work skills were compared by v 2 test. Impact of drill on severe obstetric morbidities was noted. Observations Incidence of obstetric emergencies was found to be 4.88 %. Maternal and perinatal mortality was seen in 4.23 and 37.11 %, respectively, of these emergency obstetric women. Impact of drill showed an increase in score in knowledge (p \ 0.019), confidence (p, 0.001), and team work (p \ 0.001). Conclusion Active implementation of emergency obstetric care and incorporation of obstetric drill lays a strong foundation for safe fetomaternal outcome.

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Section: Discussionsupporting

confidence: 85%

Obstetric Emergencies: Role of Obstetric Drill for a Better Maternal Outcome

Singh

Nandi

2012

J Obstet Gynecol India

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“…These services should be available at all levels where mothers give birth, since hemorrhage and preeclampsia are major causes of maternal deaths. Available evidence indicates that at least 60% of maternal and newborn deaths occur in the postpartum period [4,7], usually the first day after birth, and their management falls within the skilled attendance or emergency care strategies [7]. …”

Section: Discussionmentioning

confidence: 99%

“…The health complications of pregnant women, mothers and newborns cannot be mitigated without due attention to the quality of care [3,4]. Skilled delivery has long been indicated as the most effective intervention; but with the prevalent shortage of life-saving products and equipment, health workers cannot be expected to literally save lives with their bare hands [5].…”

Section: Introductionmentioning

confidence: 99%

Effect of support supervision on maternal and newborn health services and practices in Rural Eastern Uganda

Kisakye

Kananura

Ekirapa-Kiracho

et al. 2017

Global Health Action

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Background: Support supervision is one of the strategies used to check the quality of services provided at health facilities. From 2013 to 2015, Makerere University School of Public Health strengthened support supervision in the district of Kibuku, Kamuli and Pallisa in Eastern Uganda to improve the quality of maternal and newborn services. Objective: This article assesses quality improvements in maternal and newborn care services and practices during this period. Methods: District management teams were trained for two days on how to conduct the supportive supervision. Teams were then allocated particular facilities, which they consistently visited every quarter. During each visit, teams scored the performance of each facility based on checklists; feedback and corrective actions were implemented. Support supervision focused on maternal health services, newborn care services, human resources, laboratory services, availability of Information, education and communication materials and infrastructure. Support supervision reports and checklists from a total of 28 health facilities, each with at least three support supervision visits, were analyzed for this study and 20 key-informant interviews conducted. Results: There was noticeable improvement in maternal and newborn services. For instance, across the first, second and third quarters, availability of parenteral oxytocin increased from 57% to 75% and then to 82%. Removal of retained products increased from 14% to 50% to 54%, respectively. There was perceived improvement in the use of standards and guidelines for emergency obstetric care and quality of care provided. Qualitatively, three themes were identified that promote the success of supportive supervision: changes in the support supervision style, changes in the adherence to clinical standards and guidelines, and multi-stakeholder engagement. Conclusion: Support supervision helped district health managers to identify and address maternal and newborn service-delivery gaps. However, issues beyond the jurisdiction of district health managers and facility managers may require additional interventions beyond supportive supervision.

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“…18 Moreover, although not emphasized here, many of the interventions of proven benefit for neonates also lead to improved maternal health (detailed in Tables 4 -42), 45,710 which serves to illustrate the importance of integrating maternal and neonatal care while avoiding vertical programs for either the mother or the newborn. Although data on cost-effectiveness are particularly lacking, an approach that integrates maternal and neonatal health into Safe Motherhood and Child Survival programs and bridges the gap between these programs will not only establish continuity of care across the life cycle but will also enhance the cost-effectiveness of intervention packages.…”

Section: Implications For Programsmentioning

confidence: 99%

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

et al. 2005

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ABSTRACT. Background. Infant and under-5 childhood mortality rates in developing countries have declined significantly in the past 2 to 3 decades. However, 2 critical indicators, maternal and newborn mortality, have hardly changed. World leaders at the United Nations Millennium Summit in September 2000 agreed on a critical goal to reduce deaths of children <5 years by two thirds, but this may be unattainable without halving newborn deaths, which now comprise 40% of all under-5 deaths. Greater emphasis on wide-scale implementation of proven, cost-effective measures is required to save women's and newborns' lives. Approximately 99% of neonatal deaths take place in developing countries, mostly in homes and communities. A comprehensive review of the evidence base for impact of interventions on neonatal health and survival in developingcountry communities has not been reported.Objective. This review of community-based antenatal, intrapartum, and postnatal intervention trials in developing countries aimed to identify (1) key behaviors and interventions for which the weight of evidence is sufficient to recommend their inclusion in communitybased neonatal care programs and (2) key gaps in knowledge and priority areas for future research and program learning.Methods. Available published and unpublished data on the impact of community-based strategies and interventions on perinatal and neonatal health status outcomes were reviewed. Evidence was summarized systematically and categorized into 4 levels of evidence based on study size, location, design, and reported impact, particularly on perinatal or neonatal mortality. The evidence was placed in the context of biological plausibility of the intervention; evidence from relevant developed-country studies; health care program experience in implementation; and recommendations from the World Health Organization and other leading agencies.Results. A paucity of community-based data was found from developing-country studies on health status impact for many interventions currently being considered for inclusion in neonatal health programs. However, review of the evidence and consideration of the broader context of knowledge, experience, and recommendations regarding these interventions enabled us to categorize them according to the strength of the evidence base and confidence regarding their inclusion now in programs. This article identifies a package of priority interventions to include in programs and formulates research priorities for advancing the state of the art in neonatal health care.Conclusions. This review emphasizes some new findings while recommending an integrated approach to safe motherhood and newborn health. The results of this study provide a foundation for policies and programs related to maternal and newborn health and emphasizes the importance of health systems research and evaluation of interventions. The review offers compelling support for using research to identify the most effective measures to save newborn lives. It also may facilitate dialogue with policy...

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Maternal morbidity during labour and the puerperium in rural homes and the need for medical attention: A prospective observational study in Gadchiroli, India

Cited by 106 publications

References 16 publications

Obstetric Emergencies: Role of Obstetric Drill for a Better Maternal Outcome

Obstetric Emergencies: Role of Obstetric Drill for a Better Maternal Outcome

Effect of support supervision on maternal and newborn health services and practices in Rural Eastern Uganda

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

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