Quality and outcomes of maternal and perinatal care for 76,563 pregnancies reported in a nationwide network of Nigerian referral-level hospitals

Tukur, Jamilu; Lavin, Tina; Adanikin, Abiodun Idowu; Abdussalam, Muhammed; Bankole, Kuti; Ekott, Mabel; Godwin, Akaba; Ibrahim, Halima Abubakar; Ikechukwu, Okonkwo; Nwokeji-Onwe, Linda; Nzeribe, Emily; Ogunkunle, Taofik Oluwaseun; Lawal, Oyeneyin; Tunau, K; Bello, Musa M; Aminu, Is'haq; Ezekwe, Bosede; Aboyeji, Peter A; Adesina, Olubukola Adeponle; Chama, Calvin; Etuk, Saturday; Galadanci, Hadiza; Ikechebelu, Joseph Ifeanyichukwu; Oladapo, Olufemi T.; Adeniran, Abiodun S; Gobir, Aishatu A; Ocheke, Amaka N; Joy, Fatimah Baba; Rais, Ibrahim; Mairami, Amsa; Ozegya, Mohammed S.; Pam, Samuel; Ango, Sarah; Omoyine, Musa Abdulkarim; Patricia, Medupin; Ochejele, Silas; Agada, Egwu; Nwachukwu, D; Ahmed, Grace; Abdurrahman, Aisha; Ibrahim, Lawal; Adamu, Aisha N.; Na'uzo, Aliyu; Ashimi, Adewale; Idris, Umma; Adebola, Owodunni A; Akeredolu, Festus D; Adamu, Aliyu; Labaran, Aliyu; Oguntayo, Adekunle O; Abdulkadir, Isa; Bature, Stephen B; Ayuba, Andeyantso E; Abdullahi, Hauwa Musa; Farouk, Zubaida Ladan; Daneji, Sulaiman Muhammad; Isa, Umar; Adelaiye, Samuel; Kalle, Ismail M; Kadas, Saidu; Bashir, Muhammad Faruk; Moruppa, Joel; Bulus, Wasinda S; Yahaya, Usman R.; Jalo, Iliya; Mairiga, AG; Atterwahmie, Adamu Abdullahi; Hamza, Abdulhakeem; Wanonyi, Ishaya; John, Uniga A; Ayegbusi, Wole; Ayodeji, Adefemi; Imam, Zainab O.; Akinajo, Opeyemi; Fajolu, Iretiola; Akinsanya, Olufemi; Oluwasola, Timothy A.O.; Tongo, Olukemi O.; Jagun, Olusoji Edward; Opeyemi, Kuponiyi; Kuku, Olumide; Akindolire, Abimbola; Awonuga, David O; Dedeke, Iyabode Olabisi Florence; Akinkunmi, Francis; Olofinbiyi, Babatunde Ajayi; Olatunde, Ogundare E; Aworinde, Olufemi; Agelebe, Efeturi; Adeyanju, Olusoji; Ibijoke, Campbell; Ande, Adedapo Ba; Abbasiatai, Aniekan; Nyong, Eno Etim; Ochigbo, S O; Omo‐Aghoja, Lawrence; Ekpebe, Patrick; Njoku, Anthonia; Eigbedion, Andrew; Orazulike, Ngozi; Okechukwu, Chidiebere Emmanuel; Igbaruma, Solomon; Ebe, Idemudia; Ede-Edokpolor, Osahon; Ibeawuchi, Amarabia; Ibrahim, Isa Ayuba; Adeyemi, Oyedeji O; Mgbafulu, Chukwuemeka C; Ukamaka, Onubogu C; Ugwu, Anayochukwu; Ekwochi, Uchenna; Chioma, Obinna-Njoku; Eleje, George Uchenna; Ezenkwele, Eziamaka Pauline; Obumneme-Anyim, Ijeoma; Ojiegbe, Nnabuike O.; Nwokeforo, Nathan U; Ezebialu, Ifeanyichukwu U.; Ejiofor, Obiora Shedrack

doi:10.1016/j.eclinm.2022.101411

Cited by 24 publications

(16 citation statements)

References 23 publications

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“…43 This could reduce the burden of potentially life-threatening complications that overwhelms the tertiary health-care system. 45,46 The need for blood is universal; 47 however, present findings in Migori region indicate that access for all those who need it is not hence the urgent need for blood availability initiatives (Table 7). Literature shows an inverse relationship between the availability of blood and maternal deaths: in countries with the lowest availability of blood, maternal mortality is higher.…”

Section: Interventions Targeting Third Delaysmentioning

confidence: 81%

A Strategy for Reducing Maternal Mortality in Rural Kenya

Masaba¹,

Mmusi-Phetoe²

2023

IJWH

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Background: Migori County is categorized among regions with worst maternal survival rates in Kenya. The county's current maternal mortality ratio (MMR) is 673 deaths per 100 000 live births. A need exists for a context-specific strategy to mitigate the persistent high maternal mortalities in rural Kenya. The researchers aimed to develop a strategy for reducing the maternal mortality ratio (MMR) in Migori, Kenya. Methods: An explanatory sequential mixed methods design was utilised. The design was characterised by two separate studies, an initial quantitative followed by a qualitative study. The final phase entailed integration of data from the two separate studies. The findings, extensive literature review and three delays of maternal mortality theoretical framework informed the development of the strategy. Results:The strategy for implementation considered three strategic areas, namely, interventions targeting first delays, interventions targeting second delays, interventions targeting third delays. Conclusion:The priority interventions needed are those that enable: 1) Pregnant mothers to receive quality peripartum care in Migori hospitals, 2) Strengthened and efficient referral systems of obstetric emergencies and 3) Community knowledge empowerment on safe pregnancy and culture shift. These interventions would significantly transform the health-care system towards maternal mortality reduction. The Kenyan government and non-profit organisations should be involved in the implementation of the proposed strategy.

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Section: Interventions Targeting Third Delaysmentioning

confidence: 81%

A Strategy for Reducing Maternal Mortality in Rural Kenya

Masaba¹,

Mmusi-Phetoe²

2023

IJWH

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“…In the multivariate analysis, however, this association was lost [AOR 3.08 (95%CI 0.44-21.33); p = 0.256]. 5 AOR is adjusted odds ratio. Each variable included for multivariate analysis was adjusted for the other variables with statistically significant association in the bivariate model https://doi.org/10.1371/journal.pone.0296076.t003…”

Section: Plos Onementioning

confidence: 96%

Stillbirth incidence and determinants in a tertiary health facility in the Volta Region of Ghana

Dah,

Osarfo,

Ampofo

et al. 2023

PLoS ONE

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Background Stillbirths are indicators of the quality of obstetrics care in health systems. Stillbirth rates and their associating factors vary by socio-economic and geographical settings. Published data on stillbirths and their associating factors in the Volta Region of Ghana are limited. This limits understanding of local factors that must be considered in designing appropriate interventions to mitigate the occurrence of stillbirths. This study determined the incidence of stillbirths and associated factors among deliveries at Ho Teaching Hospital (HTH) and contributes to understanding the consistent high stillbirths in the country and potentially in other low-resourced settings in sub-Saharan Africa. Method This was a prospective cohort study involving pregnant women admitted for delivery at HTH between October 2019 and March 2020. Data on socio-demographic characteristics such as age and employment, obstetric factors including gestational age at delivery and delivery outcomes like birthweight were collected using a pretested structured questionnaire. The primary outcome was the incidence of stillbirths at the facility. Summary statistics were reported as frequencies, percentages and means. Logistic regression methods were used to assess for association between stillbirths and independent variables including age and birthweight. Odds ratios were reported with 95% confidence intervals and associations with p-values < 0.05 were considered statistically significant. Results A total of 687 women and their 702 newborns contributed data for analysis. The mean age (SD) was 29.3 (6.3) years and close to two-thirds had had at least one delivery previously. Overall stillbirth incidence was 31.3 per 1000 births. Of the 22 stillbirths, 17 were antepartum. Pre-eclampsia was the most common hypertensive disorder of pregnancy observed (49.3%, 33/67). Among others, less than 3 antenatal visits and low birthweight increased the odds of stillbirths in the bivariate analysis. In the final multivariate model, pregnancy and delivery at 28–34 weeks gestation [AOR 9.37(95% CI 1.18–74.53); p = 0.034] and induction of labour [AOR 11.06 (95% CI 3.10–39.42); p < 0.001] remained significantly associated with stillbirths. Conclusion Stillbirth incidence was 31.3 per 1000 births with more than half being antepartum stillbirths. Pregnancy/delivery at 28–34 weeks’ gestation increased the odds of a stillbirth. Improving the quality of antenatal services, ensuring adherence to evidence-based protocols, accurate and prompt diagnosis and timely interventions of medical conditions in pregnancy particularly at 28–34 weeks’ gestation could reduce incidence of stillbirths.

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“…Emphasis has been on pregnant and breastfeeding mothers, who constitute the highest proportion of global deaths from preventable causes, given the complicated cascade of events resulting in pre- and postpartum deaths [ 3 ]. Nigeria, for instance, contributed 14% of the global maternal deaths in 2020, with over 58,000 women dying pregnancy-related deaths, one of the highest maternal mortality rates globally [ 4 , 5 ]. The Nigeria Centre for Disease Control and Prevention (NCDC) December 2021 data showed that women had less mortality from COVID-19 compared to men [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…The COVID-19 pandemic had a far-reaching global impact with overwhelming effects on health systems, especially in countries like Nigeria with poorly managed health systems. Like many other sub-Saharan African countries, Nigeria faces considerable impediments to women’s access to healthcare owing to factors such as poverty, limited education, and cultural norms prioritizing men over women [ 4 , 10 , 11 , 12 , 13 ]. The challenge of accessing health care has plagued Nigeria since before the COVID-19 pandemic, with several studies echoing women’s health behavior fluctuating between biomedical and non-biomedical care [ 8 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

“We Live Our Life Normal”: A Qualitative Analysis of Nigerian Women’s Health-Seeking Behavior during the COVID-19 Pandemic

Ndu,

Teachman,

Martin

et al. 2024

IJERPH

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Background: This study examined where women sought healthcare during the COVID-19 pandemic and their reasons for doing so. We aim to understand further how women accessed care during the COVID-19 pandemic to inform future preparedness and response efforts. This knowledge gained from this study can inform strategies to address existing gaps in access and ensure that women’s health needs are adequately considered during emergencies. Methods: This study used an interpretive phenomenological-analysis approach to analyze data on women’s experiences with healthcare in Nigeria as the COVID-19 pandemic progressed. Semi-structured interviews were conducted with 24 women aged 15 to 49 between August and November 2022 and were supplemented with three focus-group discussions. Results: Following our analysis, three superordinate themes emerged: (i) barriers to seeking timely and appropriate healthcare care, (ii) the influence of diverse health practices and beliefs on health-seeking behavior, and (iii) gendered notions of responsibility and of coping with financial challenges. Conclusions: This paper examined women’s decision to seek or not seek care, the type of care they received, and where they went for care. Women felt that the COVID-19 pandemic affected their decision to seek or not seek care.

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Quality and outcomes of maternal and perinatal care for 76,563 pregnancies reported in a nationwide network of Nigerian referral-level hospitals

Cited by 24 publications

References 23 publications

A Strategy for Reducing Maternal Mortality in Rural Kenya

A Strategy for Reducing Maternal Mortality in Rural Kenya

Stillbirth incidence and determinants in a tertiary health facility in the Volta Region of Ghana

“We Live Our Life Normal”: A Qualitative Analysis of Nigerian Women’s Health-Seeking Behavior during the COVID-19 Pandemic

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