Message in a bottle: sinking in a sea of safe motherhood concepts

Hussein, Julia; Clapham, S.

doi:10.1016/j.healthpol.2004.11.021

Cited by 26 publications

(19 citation statements)

References 13 publications

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“…Donors support vertical programs because their monitoring and evaluation is easier and their results are available quickly. But vertical programs may erode the general standards of health systems by diverting resources from overall quality and focusing on a single problem [17]. …”

Section: Discussionmentioning

confidence: 99%

Impact of community-based interventions on maternal and neonatal health indicators: Results from a community randomized trial in rural Balochistan, Pakistan

2010

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BackgroundPakistan has high maternal mortality, particularly in the rural areas. The delay in decision making to seek medical care during obstetric emergencies remains a significant factor in maternal mortality.MethodsWe present results from an experimental study in rural Pakistan. Village clusters were randomly assigned to intervention and control arms (16 clusters each). In the intervention clusters, women were provided information on safe motherhood through pictorial booklets and audiocassettes; traditional birth attendants were trained in clean delivery and recognition of obstetric and newborn complications; and emergency transportation systems were set up. In eight of the 16 intervention clusters, husbands also received specially designed education materials on safe motherhood and family planning. Pre- and post-intervention surveys on selected maternal and neonatal health indicators were conducted in all 32 clusters. A district-wide survey was conducted two years after project completion to measure any residual impact of the interventions.ResultsPregnant women in intervention clusters received prenatal care and prophylactic iron therapy more frequently than pregnant women in control clusters. Providing safe motherhood education to husbands resulted in further improvement of some indicators. There was a small but significant increase in percent of hospital deliveries but no impact on the use of skilled birth attendants. Perinatal mortality reduced significantly in clusters where only wives received information and education in safe motherhood. The survey to assess residual impact showed similar results.ConclusionsWe conclude that providing safe motherhood education increased the probability of pregnant women having prenatal care and utilization of health services for obstetric complications.

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Section: Discussionmentioning

confidence: 99%

Impact of community-based interventions on maternal and neonatal health indicators: Results from a community randomized trial in rural Balochistan, Pakistan

2010

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“…Specific packages and standards for EmOC have been defined for different levels of the health system, although overlap and ambiguity in contents of various obstetric care packages have generated substantial confusion and debate [132,133]. Ideally, all women would have access to essential obstetric care, which includes intrapartum monitoring with early detection and management or referral of complications.…”

Section: Intrapartum Care Packagesmentioning

confidence: 99%

Obstetric care in low-resource settings: What, who, and how to overcome challenges to scale up?

Hofmeyr

Haws

Bergström

et al. 2009

International Journal of Gynecology & Obstetrics

198

176

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“…In their ‘Guidelines for monitoring the availability and use of obstetric services’, UNICEF, WHO and UNFPA (1997) promoted a set of process indicators, the first of which is emergency obstetric care (EmOC) facility density [although they refer to it as essential obstetric care (Hussein & Clapham 2005)]. EmOC comprises basic emergency obstetric care (BEmOC), which can be provided by skilled birth attendants, such as midwives or doctors, at a well‐equipped health centre, and comprehensive EmOC (CEmOC), which requires surgical skills and thus is usually provided by doctors in a hospital setting.…”

Section: Introductionmentioning

confidence: 99%

Emergency obstetric care availability: a critical assessment of the current indicator

Gabrysch

Zanger

Campbell

2011

Tropical Med Int Health

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Monitoring progress in reducing maternal and perinatal mortality requires suitable indicators. The density of emergency obstetric care (EmOC) facilities has been proposed as a potentially useful indicator, but different UN documents make inconsistent recommendations, and its current formulation is not associated with maternal mortality. We compiled recently published indicator benchmarks and distinguished three sources of inconsistency: (i) use of different denominator metrics (per birth and per population), (ii) different assumptions on need for EmOC and for EmOC facilities and (iii) failure to specify facility capacity (birth load). The UN guidelines and handbook require fewer EmOC facilities than the World Health Report 2005 and do not specify capacity for deliveries or staffing levels. We recommend (i) always using births as the denominator for EmOC facility density, (ii) clearly stating assumptions on the proportion of deliveries needing basic and comprehensive emergency obstetric care and the desired proportion of deliveries in EmOC facilities and (iii) specifying facility capacity and staffing and adapting benchmarks for settings with different population density to ensure geographical accessibility.

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Message in a bottle: sinking in a sea of safe motherhood concepts

Cited by 26 publications

References 13 publications

Impact of community-based interventions on maternal and neonatal health indicators: Results from a community randomized trial in rural Balochistan, Pakistan

Impact of community-based interventions on maternal and neonatal health indicators: Results from a community randomized trial in rural Balochistan, Pakistan

Obstetric care in low-resource settings: What, who, and how to overcome challenges to scale up?

Emergency obstetric care availability: a critical assessment of the current indicator

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