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PubMed · 1354177

Maternal mortality: community-based interventions.

Abstract

Maternal mortality is one of the great neglected problems of health care in developing countries. The World Health Organization estimates that approximately 500,000 women die each year from pregnancy-related causes, over 98% of these deaths occurring in the developing world, where maternal mortality is as much as 100 times higher than rates seen in industrialized countries. The most common causes include obstructed labor and ruptured uterus, postpartum hemorrhage, eclampsia, postpartum infection and complications of illegal abortion. It is suggested that no new or costly technologies are needed; rather that appropriate priority setting and allocation of needed resources are essential to the solution of the problem. There are few interventions that hold much hope of success at the village level, although antibiotics, ergotrate, and sedatives might be productively utilized, after appropriate training. Overall, however, networks of maternity care facilities, trained personnel, and means of transport are necessary to provide needed emergency maternity care services.

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BibTeXRIS

A Rosenfield. 1992. Maternal mortality: community-based interventions.. https://doi.org/10.1016/0020-7292(92)90024-d

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Karawa Health Zone (KHZ) located in northwestern Zaire, comprises 19,000 km2 with about 340,000 inhabitants. As part of an expanding primary health care program, KHZ officials instituted an extensive outreach program to increase access of women to maternity care. General practitioner (GP) doctors, nurses, midwives, auxiliaries, and traditional birth attendants share responsibilities in delivering maternity care services. Nurses and midwives perform most of the obstetric functions at the Karawa Hospital Maternity Center. Data from 1988 to 1990 show that nurses and midwives attended 98% of normal deliveries and 81% of the complicated ones. Selected nurses performed cesarean section routinely. There was no significant difference in maternal and neonatal outcomes for cesarean section performed by nurses and GPs. Physicians on staff provided support through monitoring, supervision, training, and care for the most complicated cases.

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