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Moving beyond essen...
Moving beyond essential interventions for reduction of maternal mortality (the WHO Multicountry Survey on Maternal and Newborn Health) : a cross-sectional study
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- Souza, João Paulo (författare)
- UNDP/UNFPA/UNICEF/WHO/Word Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland
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- Gülmezoglu, Ahmet Metin (författare)
- UNDP/UNFPA/UNICEF/WHO/Word Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland
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- Vogel, Joshua (författare)
- UNDP/UNFPA/UNICEF/WHO/Word Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland
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- Carroli, Guillermo (författare)
- Centro Rosarino de Estudios Perinatales, Rosario, Argentina
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- Lumbiganon, Pisake (författare)
- Khon Kaen University, Khon Kaen, Thailand
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- Qureshi, Zahida (författare)
- University of Nairobi, Nairobi, Kenya
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- Costa, Maria José (författare)
- WHO Angola, Luanda, Angola
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- Fawole, Bukola (författare)
- University of Ibadan, Ibadan, Nigeria
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- Mugerwa, Yvonne (författare)
- Makerere University, Makerere, Uganda
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- Nafiou, Idi (författare)
- Université Abdou Moumouni de Niamey, Niamey, Niger
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- Neves, Isilda (författare)
- Delegação Provincial de Saúde de Luanda, Luanda, Angola
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- Wolomby-Molondo, Jean-José (författare)
- Cliniques Universitaires de Kinshasa, Kinshasa, DR Congo
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- Bang, Hoang Thi (författare)
- WHO, Hanoi, Vietnam
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- Cheang, Kannitha (författare)
- WHO, Phnom Penh, Cambodia
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- Chuyun, Kang (författare)
- Peking University, Beijing, China
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- Jayaratne, Kapila (författare)
- Ministry of Health, Government of Sri Lanka, Colombo, Sri Lanka
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- Jayathilaka, Chandani Anoma (författare)
- WHO, Colombo, Sri Lanka
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- Mazhar, Syeda Batool (författare)
- Pakistan Institute of Medical Sciences, Islamabad, Pakistan
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- Mori, Rintaro (författare)
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
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- Mustafa, Mir Lais (författare)
- Afghan Public Health Institute, Kabul, Afghanistan
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- Pathak, Laxmi Raj (författare)
- Ministry of Health and Population, Government of Nepal, Kathmandu, Nepal
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- Perera, Deepthi (författare)
- Ministry of Health, Government of Sri Lanka, Colombo, Sri Lanka
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- Rathavy, Tung (författare)
- National Maternal and Child Health Center, Phnom Penh, Cambodia
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- Recidoro, Zenaida (författare)
- National Center for Disease Prevention and Control, Manila, Philippines
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- Roy, Malabika (författare)
- Indian Council of Medical Research, New Delhi, India
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- Ruyan, Pang (författare)
- Peking University, Beijing, China
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- Shrestha, Naveen (författare)
- Central Institute of Science and Technology (CIST) College, Pokhara University, Kathmandu, Nepal
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- Taneepanichsku, Surasak (författare)
- Chulalongkorn University, Bangkok, Thailand
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- Tien, Nguyen Viet (författare)
- National Obstetrics and Gynaecology Hospital, Hanoi, Vietnam
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- Ganchimeg, Togoobaatar (författare)
- The University of Tokyo, Tokyo, Japan
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- Wehbe, Mira (författare)
- American University of Beirut, Beirut, Lebanon
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- Yadamsuren, Buyanjargal (författare)
- Ministry of Health, Government of Mongolia, Ulaanbaatar, Mongolia
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- Yan, Wang (författare)
- Peking University, Beijing, China
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- Yunis, Khalid (författare)
- American University of Beirut, Beirut, Lebanon
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- Bataglia, Vicente (författare)
- Hospital Nacional de Itauguá, Itauguá, Paraguay
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- Cecatti, José Guilherme (författare)
- University of Campinas, Campinas, SP, Brazil
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- Hernandez-Prado, Bernardo (författare)
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
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- Nardin, Juan Manuel (författare)
- Centro Rosarino de Estudios Perinatales, Rosario, Argentina
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- Narváez, Alberto (författare)
- Colegio Medico de Pichincha and Fundación Salud, Ambiente y Desarollo, Pichincha, Ecuador
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- Ortiz-Panozo, Eduardo (författare)
- Instituto Nacional de Salud Pública, Cuernavaca, Mexico
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- Pérez-Cuevas, Ricardo (författare)
- Social Protection and Health Division, Inter American Development Bank, Mexico City, Mexico
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- Valladares, Eliette (författare)
- Universidad Nacional Autónoma de Nicaragua, León, Nicaragua
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- Zavaleta, Nelly (författare)
- Instituto de Investigación Nutricional, Lima, Peru
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- Armson, Anthony (författare)
- Dalhousie University, Halifax, Canada
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- Crowther, Caroline (författare)
- University of Adelaide, Adelaide, Australia
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- Hogue, Carol (författare)
- Emory University, Atlanta, GA, USA
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- Lindmark, Gunilla, 1941- (författare)
- Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH),Internationell kvinno- & mödrahälsovård/Essén
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- Mittal, Suneeta (författare)
- All India Institute of Medical Sciences, New Delhi, India
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- Pattinson, Robert (författare)
- University of Pretoria, Pretoria, South Africa
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- Stanton, Mary Ellen (författare)
- United States Agency for International Development, Washington, DC, USA
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- Campodonico, Liana (författare)
- Centro Rosarino de Estudios Perinatales, Rosario, Argentina
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- Cuesta, Cristina (författare)
- Centro Rosarino de Estudios Perinatales, Rosario, Argentina
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- Giordano, Daniel (författare)
- Centro Rosarino de Estudios Perinatales, Rosario, Argentina
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- Intarut, Nirun (författare)
- Chulalongkorn University, Bangkok, Thailand
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- Laopaiboon, Malinee (författare)
- Khon Kaen University, Khon Kaen, Thailand
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- Bahl, Rajiv (författare)
- WHO, Geneva, Switzerland
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- Martines, Jose (författare)
- WHO, Geneva, Switzerland
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- Mathai, Matthews (författare)
- WHO, Geneva, Switzerland
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- Merialdi, Mario (författare)
- UNDP/UNFPA/UNICEF/WHO/Word Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland
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- Say, Lale (författare)
- UNDP/UNFPA/UNICEF/WHO/Word Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland
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(creator_code:org_t)
- 2013
- 2013
- Engelska.
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Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 381:9879, s. 1747-1755
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- BACKGROUND: We report the main findings of the WHO Multicountry Survey on Maternal and Newborn Health (WHOMCS), which aimed to assess the burden of complications related to pregnancy, the coverage of key maternal health interventions, and use of the maternal severity index (MSI) in a global network of health facilities.METHODS: In our cross-sectional study, we included women attending health facilities in Africa, Asia, Latin America, and the Middle East that dealt with at least 1000 childbirths per year and had the capacity to provide caesarean section. We obtained data from analysis of hospital records for all women giving birth and all women who had a severe maternal outcome (SMO; ie, maternal death or maternal near miss). We regarded coverage of key maternal health interventions as the proportion of the target population who received an indicated intervention (eg, the proportion of women with eclampsia who received magnesium sulphate). We used areas under the receiver operator characteristic curves (AUROC) with 95% CI to externally validate a previously reported MSI as an indicator of severity. We assessed the overall performance of care (ie, the ability to produce a positive effect on health outcomes) through standardised mortality ratios.RESULTS: From May 1, 2010, to Dec 31, 2011, we included 314,623 women attending 357 health facilities in 29 countries (2538 had a maternal near miss and 486 maternal deaths occurred). The mean period of data collection in each health facility was 89 days (SD 21). 23,015 (7.3%) women had potentially life-threatening disorders and 3024 (1.0%) developed an SMO. 808 (26.7%) women with an SMO had post-partum haemorrhage and 784 (25.9%) had pre-eclampsia or eclampsia. Cardiovascular, respiratory, and coagulation dysfunctions were the most frequent organ dysfunctions in women who had an SMO. Reported mortality in countries with a high or very high maternal mortality ratio was two-to-three-times higher than that expected for the assessed severity despite a high coverage of essential interventions. The MSI had good accuracy for maternal death prediction in women with markers of organ dysfunction (AUROC 0.826 [95% CI 0.802-0.851]).INTERPRETATION: High coverage of essential interventions did not imply reduced maternal mortality in the health-care facilities we studied. If substantial reductions in maternal mortality are to be achieved, universal coverage of life-saving interventions need to be matched with comprehensive emergency care and overall improvements in the quality of maternal health care. The MSI could be used to assess the performance of health facilities providing care to women with complications related to pregnancy.
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Souza, João Paul ...
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Gülmezoglu, Ahme ...
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Vogel, Joshua
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Carroli, Guiller ...
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Lumbiganon, Pisa ...
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Qureshi, Zahida
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visa fler...
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Costa, Maria Jos ...
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Fawole, Bukola
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Mugerwa, Yvonne
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Nafiou, Idi
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Neves, Isilda
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Wolomby-Molondo, ...
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Bang, Hoang Thi
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Cheang, Kannitha
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Chuyun, Kang
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Jayaratne, Kapil ...
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Jayathilaka, Cha ...
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Mazhar, Syeda Ba ...
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Mori, Rintaro
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Mustafa, Mir Lai ...
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Pathak, Laxmi Ra ...
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Perera, Deepthi
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Rathavy, Tung
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Recidoro, Zenaid ...
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Roy, Malabika
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Ruyan, Pang
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Shrestha, Naveen
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Taneepanichsku, ...
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Tien, Nguyen Vie ...
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Ganchimeg, Togoo ...
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Wehbe, Mira
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Yadamsuren, Buya ...
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Yan, Wang
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Yunis, Khalid
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Bataglia, Vicent ...
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Cecatti, José Gu ...
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Hernandez-Prado, ...
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Nardin, Juan Man ...
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Narváez, Alberto
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Ortiz-Panozo, Ed ...
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Pérez-Cuevas, Ri ...
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Valladares, Elie ...
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Zavaleta, Nelly
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Armson, Anthony
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Crowther, Caroli ...
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Hogue, Carol
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Lindmark, Gunill ...
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Mittal, Suneeta
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Pattinson, Rober ...
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Stanton, Mary El ...
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Campodonico, Lia ...
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Cuesta, Cristina
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Giordano, Daniel
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Intarut, Nirun
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Laopaiboon, Mali ...
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Bahl, Rajiv
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Martines, Jose
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Mathai, Matthews
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Merialdi, Mario
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Say, Lale
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- Artiklar i publikationen
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The Lancet
- Av lärosätet
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Uppsala universitet