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  • Souza, João PauloUNDP/UNFPA/UNICEF/WHO/Word Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland (författare)

Moving beyond essential interventions for reduction of maternal mortality (the WHO Multicountry Survey on Maternal and Newborn Health) : a cross-sectional study

  • Artikel/kapitelEngelska2013

Förlag, utgivningsår, omfång ...

  • 2013
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:uu-200409
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-200409URI
  • https://doi.org/10.1016/S0140-6736(13)60686-8DOI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

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Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • FUNDING: UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP); WHO; USAID; Ministry of Health, Labour and Welfare of Japan; Gynuity Health Projects.
  • 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.

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Gülmezoglu, Ahmet MetinUNDP/UNFPA/UNICEF/WHO/Word Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland (författare)
  • Vogel, JoshuaUNDP/UNFPA/UNICEF/WHO/Word Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland (författare)
  • Carroli, GuillermoCentro Rosarino de Estudios Perinatales, Rosario, Argentina (författare)
  • Lumbiganon, PisakeKhon Kaen University, Khon Kaen, Thailand (författare)
  • Qureshi, ZahidaUniversity of Nairobi, Nairobi, Kenya (författare)
  • Costa, Maria JoséWHO Angola, Luanda, Angola (författare)
  • Fawole, BukolaUniversity of Ibadan, Ibadan, Nigeria (författare)
  • Mugerwa, YvonneMakerere University, Makerere, Uganda (författare)
  • Nafiou, IdiUniversité Abdou Moumouni de Niamey, Niamey, Niger (författare)
  • Neves, IsildaDelegação Provincial de Saúde de Luanda, Luanda, Angola (författare)
  • Wolomby-Molondo, Jean-JoséCliniques Universitaires de Kinshasa, Kinshasa, DR Congo (författare)
  • Bang, Hoang ThiWHO, Hanoi, Vietnam (författare)
  • Cheang, KannithaWHO, Phnom Penh, Cambodia (författare)
  • Chuyun, KangPeking University, Beijing, China (författare)
  • Jayaratne, KapilaMinistry of Health, Government of Sri Lanka, Colombo, Sri Lanka (författare)
  • Jayathilaka, Chandani AnomaWHO, Colombo, Sri Lanka (författare)
  • Mazhar, Syeda BatoolPakistan Institute of Medical Sciences, Islamabad, Pakistan (författare)
  • Mori, RintaroDepartment of Health Policy, National Center for Child Health and Development, Tokyo, Japan (författare)
  • Mustafa, Mir LaisAfghan Public Health Institute, Kabul, Afghanistan (författare)
  • Pathak, Laxmi RajMinistry of Health and Population, Government of Nepal, Kathmandu, Nepal (författare)
  • Perera, DeepthiMinistry of Health, Government of Sri Lanka, Colombo, Sri Lanka (författare)
  • Rathavy, TungNational Maternal and Child Health Center, Phnom Penh, Cambodia (författare)
  • Recidoro, ZenaidaNational Center for Disease Prevention and Control, Manila, Philippines (författare)
  • Roy, MalabikaIndian Council of Medical Research, New Delhi, India (författare)
  • Ruyan, PangPeking University, Beijing, China (författare)
  • Shrestha, NaveenCentral Institute of Science and Technology (CIST) College, Pokhara University, Kathmandu, Nepal (författare)
  • Taneepanichsku, SurasakChulalongkorn University, Bangkok, Thailand (författare)
  • Tien, Nguyen VietNational Obstetrics and Gynaecology Hospital, Hanoi, Vietnam (författare)
  • Ganchimeg, TogoobaatarThe University of Tokyo, Tokyo, Japan (författare)
  • Wehbe, MiraAmerican University of Beirut, Beirut, Lebanon (författare)
  • Yadamsuren, BuyanjargalMinistry of Health, Government of Mongolia, Ulaanbaatar, Mongolia (författare)
  • Yan, WangPeking University, Beijing, China (författare)
  • Yunis, KhalidAmerican University of Beirut, Beirut, Lebanon (författare)
  • Bataglia, VicenteHospital Nacional de Itauguá, Itauguá, Paraguay (författare)
  • Cecatti, José GuilhermeUniversity of Campinas, Campinas, SP, Brazil (författare)
  • Hernandez-Prado, BernardoInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA (författare)
  • Nardin, Juan ManuelCentro Rosarino de Estudios Perinatales, Rosario, Argentina (författare)
  • Narváez, AlbertoColegio Medico de Pichincha and Fundación Salud, Ambiente y Desarollo, Pichincha, Ecuador (författare)
  • Ortiz-Panozo, EduardoInstituto Nacional de Salud Pública, Cuernavaca, Mexico (författare)
  • Pérez-Cuevas, RicardoSocial Protection and Health Division, Inter American Development Bank, Mexico City, Mexico (författare)
  • Valladares, ElietteUniversidad Nacional Autónoma de Nicaragua, León, Nicaragua (författare)
  • Zavaleta, NellyInstituto de Investigación Nutricional, Lima, Peru (författare)
  • Armson, AnthonyDalhousie University, Halifax, Canada (författare)
  • Crowther, CarolineUniversity of Adelaide, Adelaide, Australia (författare)
  • Hogue, CarolEmory University, Atlanta, GA, USA (författare)
  • Lindmark, Gunilla,1941-Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH),Internationell kvinno- & mödrahälsovård/Essén(Swepub:uu)gunilind (författare)
  • Mittal, SuneetaAll India Institute of Medical Sciences, New Delhi, India (författare)
  • Pattinson, RobertUniversity of Pretoria, Pretoria, South Africa (författare)
  • Stanton, Mary EllenUnited States Agency for International Development, Washington, DC, USA (författare)
  • Campodonico, LianaCentro Rosarino de Estudios Perinatales, Rosario, Argentina (författare)
  • Cuesta, CristinaCentro Rosarino de Estudios Perinatales, Rosario, Argentina (författare)
  • Giordano, DanielCentro Rosarino de Estudios Perinatales, Rosario, Argentina (författare)
  • Intarut, NirunChulalongkorn University, Bangkok, Thailand (författare)
  • Laopaiboon, MalineeKhon Kaen University, Khon Kaen, Thailand (författare)
  • Bahl, RajivWHO, Geneva, Switzerland (författare)
  • Martines, JoseWHO, Geneva, Switzerland (författare)
  • Mathai, MatthewsWHO, Geneva, Switzerland (författare)
  • Merialdi, MarioUNDP/UNFPA/UNICEF/WHO/Word Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland (författare)
  • Say, LaleUNDP/UNFPA/UNICEF/WHO/Word Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, Switzerland (författare)
  • UNDP/UNFPA/UNICEF/WHO/Word Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Geneva, SwitzerlandCentro Rosarino de Estudios Perinatales, Rosario, Argentina (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:The Lancet381:9879, s. 1747-17550140-67361474-547X

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