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Klingberg-Allvin, MarieORCID iD iconorcid.org/0000-0002-8947-2949
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Klingberg-Allvin, M., Hatakka, M., Erlandsson, K., Osman, F., Byrskog, U. & Egal, J. (2019). "Change-makers in midwifery care": Exploring the differences between expectations and outcomes - a qualitative study of a midwifery net-based education programme in the Somali region. Midwifery, 69, 135-142
Öppna denna publikation i ny flik eller fönster >>"Change-makers in midwifery care": Exploring the differences between expectations and outcomes - a qualitative study of a midwifery net-based education programme in the Somali region
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2019 (Engelska)Ingår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 69, s. 135-142Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

The aim of this study is to explore midwifery educators’ expected outcomes in the net-based master's programme, the programmes’ realised outcomes and the reported difference regarding the increased choices for the graduates and the effect on their agency.

Design

In this case study, we focused on a net-based master's programme in sexual and reproductive health in Somalia. Somalia suffers from a shortage of skilled birth attendants and there is a need for building up the capacity of midwifery educators.

Setting and participants

Data was collected in focus group discussions at the start of the programme and eight months after the students graduated. The data were analysed through the lens of the choice framework, which is based on the capability approach.

Findings

Findings show that many of the graduates’ expectations were met, while some were more difficult to fulfil. While the midwives’ choices and resource portfolios had improved because of their role as educators, the social structure prevented them from acting on their agency, specifically in regards to making changes at the social level. Several of the positive developments can be attributed to the pedagogy and structure of the programme.

Conclusion

The flexibility of net-based education gave the midwifery educators a new educational opportunity that they previously did not have. Students gained increased power and influence on some levels. However, they still lack power in government organisations where, in addition to their role as educators, they could use their skills and knowledge to change policies at the social level.

Nyckelord
Net-based education, Quality midwifery education, Midwifery care, Somaliland, Capability approach, Choice framework
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Forskningsämne
Hälsa och välfärd
Identifikatorer
urn:nbn:se:du-29004 (URN)10.1016/j.midw.2018.11.007 (DOI)000454129800018 ()30503998 (PubMedID)2-s2.0-85057779256 (Scopus ID)
Tillgänglig från: 2018-12-03 Skapad: 2018-12-03 Senast uppdaterad: 2019-01-10Bibliografiskt granskad
Emtell Iwarsson, K., Larsson, E. C., Gemzell-Danielsson, K., Essén, B. & Klingberg-Allvin, M. (2019). Contraceptive use among migrant, second-generation migrant and non-migrant women seeking abortion care: a descriptive cross-sectional study conducted in Sweden. BMJ Sexual and Reproductive Health, 45(2), 118-126
Öppna denna publikation i ny flik eller fönster >>Contraceptive use among migrant, second-generation migrant and non-migrant women seeking abortion care: a descriptive cross-sectional study conducted in Sweden
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2019 (Engelska)Ingår i: BMJ Sexual and Reproductive Health, ISSN 2515-1991, Vol. 45, nr 2, s. 118-126Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Introduction: The objective of this study was to compare ever-in life contraception use, use of contraception at current conception, and planned use of contraception after an induced abortion, among three groups of women: migrants, second-generation migrants and non-migrant women, and to compare the types of contraception methods used and intended for future use among the three groups of women. Methods: The cross-sectional study administered a questionnaire face-to-face to women aged 18 years and older who were seeking abortion care at one of six abortion clinics in Stockholm County from January to April 2015. Results: The analysis included 637 women. Migrants and second-generation migrants were less likely to have used contraception historically, at the time of the current conception, and to plan to use contraception after their induced abortion compared with non-migrant women. Historically, non-migrants had used pills (89%) and withdrawal (24%) while migrants had used the copper intrauterine device (24%) to a higher extent compared to the other two groups of women. Both the migrants (65%) and second-generation migrants (61%) were more likely than the non-migrants (48%) to be planning to use long-acting reversible contraception. Conclusions: Lower proportions of contraception use were found in migrants and second-generation migrants than in non-migrants. In addition, there were significant differences in the types of contraception methods used historically and intended for future use.

Nyckelord
contraception, counselling, ethnic minority migrants, induced abortion
Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
Hälsa och välfärd
Identifikatorer
urn:nbn:se:du-29360 (URN)10.1136/bmjsrh-2018-200171 (DOI)000471856700007 ()2-s2.0-85060383211 (Scopus ID)
Tillgänglig från: 2019-02-04 Skapad: 2019-02-04 Senast uppdaterad: 2019-07-04Bibliografiskt granskad
diva2:1343284
Öppna denna publikation i ny flik eller fönster >>Evaluating a model for the capacity building of midwifery eduators in Bangladesh through a blended, web-based master's programme
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2019 (Engelska)Ingår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 12, nr 1, artikel-id 1652022Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: While setting international standards for midwifery education has attracted considerable global attention, the education and training of midwifery educators has been relatively neglected, particularly in low-resource settings where capacity building is crucial. Objective: The aim of this study was to describe the expectations of midwifery educators in Bangladesh who took part in a blended web-based master's programme in SRHR and the extent to which these were realized after 12 months of part-time study. Methods: Both quantitative and qualitative methods have been used to collect data. A structured baseline questionnaire was distributed to all participants at the start of the first course (n = 30) and a second endpoint questionnaire was distributed after they (n = 29) had completed the core courses one year later. At the start of the first course, five focus group discussions (FGD) were held with the midwifery educators. Descriptive statistics and content analysis were used for the analyses. Results: Midwifery educators who took part in the study identified expectations that can be grouped into three distinct areas. They hoped to become more familiar with technology, anticipated they would learn pedagogical and other skills that would enable them to better support their students' learning and thought they might acquire skills to empower their students as human beings. Participants reported they realized these ambitions, attributing the master's programme with helping them take responsibility for their own teaching and learning, showing them how to enhance their students' learning and how to foster reflective and critical thinking among them. Conclusions: Midwifery educators have taken part in a creative learning environment which has developed their engagement in teaching and learning. They have done this using a blended learning model which combines online learning with face-to-face contact. This model can be scaled up in low resource and remote settings.

Nyckelord
Bangladesh, Midwifery education, South Asia, capacity building, web-based education
Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
Hälsa och välfärd
Identifikatorer
urn:nbn:se:du-30616 (URN)10.1080/16549716.2019.1652022 (DOI)000480727300001 ()31411128 (PubMedID)
Tillgänglig från: 2019-08-16 Skapad: 2019-08-16 Senast uppdaterad: 2019-08-29Bibliografiskt granskad
Atuhairwe, S., Byamugisha, J., Klingberg-Allvin, M., Cleeve, A., Hanson, C., Tumwesigye, N. M., . . . Danielsson, K. G. (2019). Evaluating the safety, effectiveness and acceptability of treatment of incomplete second-trimester abortion using misoprostol provided by midwives compared with physicians: study protocol for a randomized controlled equivalence trial. Trials, 20(1), Article ID 376.
Öppna denna publikation i ny flik eller fönster >>Evaluating the safety, effectiveness and acceptability of treatment of incomplete second-trimester abortion using misoprostol provided by midwives compared with physicians: study protocol for a randomized controlled equivalence trial
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2019 (Engelska)Ingår i: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 20, nr 1, artikel-id 376Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: A large proportion of abortion-related mortality and morbidity occurs in the second trimester of pregnancy. The Uganda Ministry of Health policy restricts management of second-trimester incomplete abortion to physicians who are few and unequally distributed, with most practicing in urban regions. Unsafe and outdated methods like sharp curettage are frequently used. Medical management of second-trimester post-abortion care by midwives offers an advantage given the difficulty in providing surgical management in low-income settings and current health worker shortages. The study aims to assess the safety, effectiveness and acceptability of treatment of incomplete second-trimester abortion using misoprostol provided by midwives compared with physicians.

METHODS: A randomized controlled equivalence trial implemented at eight hospitals and health centers in Central Uganda will include 1192 eligible women with incomplete abortion of uterine size > 12 weeks up to 18 weeks. Each participant will be randomly assigned to undergo a clinical assessment and treatment by either a midwife (intervention arm) or a physician (control arm). Enrolled participants will receive 400 μg misoprostol administered sublingually every 3 h up to five doses within 24 h at the health facility until a complete abortion is confirmed. Women who do not achieve complete abortion within 24 h will undergo surgical uterine evacuation. Pre discharge, participants will receive contraceptive counseling and information on what to expect in terms of side effects and signs of complications, with follow-up 14 days later to assess secondary outcomes. Analyses will be by intention to treat. Background characteristics and outcomes will be presented using descriptive statistics. Differences between groups will be analyzed using risk difference (95% confidence interval) and equivalence established if this lies between the predefined range of - 5% and + 5%. Chi-square tests will be used for comparison of outcome and t tests used to compare mean values. P ≤ 0.05 will be considered statistically significant.

DISCUSSION: Our study will provide evidence to inform national and international policies, standard care guidelines and training program curricula on treatment of second-trimester incomplete abortion for improved access.

TRIAL REGISTRATION: ClinicalTrials.gov, NCT03622073 . Registered on 9 August 2018.

Nyckelord
Contraception, Incomplete abortion, Misoprostol, Post abortion care, Second trimester, Task sharing, Uganda
Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
Hälsa och välfärd
Identifikatorer
urn:nbn:se:du-30380 (URN)10.1186/s13063-019-3490-5 (DOI)000472522500003 ()31227019 (PubMedID)2-s2.0-85068536981 (Scopus ID)
Tillgänglig från: 2019-06-25 Skapad: 2019-06-25 Senast uppdaterad: 2019-07-23Bibliografiskt granskad
Cleeve, A., Nalwadda, G., Zadik, T., Sterner, K. & Klingberg-Allvin, M. (2019). Morality versus duty - A qualitative study exploring midwives' perspectives on post-abortion care in Uganda. Midwifery, 77, 71-77
Öppna denna publikation i ny flik eller fönster >>Morality versus duty - A qualitative study exploring midwives' perspectives on post-abortion care in Uganda
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2019 (Engelska)Ingår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 77, s. 71-77Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVE: We aimed to explore midwives' perspectives on post-abortion care (PAC) in Uganda. Specifically, we sought to improve understanding of the quality of care.

DESIGN: This was a qualitative study using individual in-depth interviews and an inductive thematic analysis.

SETTING AND PARTICIPANTS: Interviews were conducted with 22 midwives (the 'informants') providing PAC in a public hospital in Kampala, Uganda. The narratives were based on experiences in current and previous workplaces, in rural and urban settings.

FINDINGS: The findings comprise one main theme - morality versus duty to provide quality post-abortion care - and three sub-themes. Our findings confirm that the midwives were committed to saving women's lives but had conflicting personal morality in relation to abortion and sense of professional duty, which seemed to influence their quality of care. Midwives were proud to provide PAC, which was described as a natural part of midwifery. However, structural challenges, such as lack of supplies and equipment and high patient loads, hampered provision of good quality care and left informants feeling frustrated. Although abortion was often implied to be immoral, the experience of PAC provision appeared to shape views on legality, leading to an ambiguous, yet more liberal, stance. Abortion stigma was reported to exist within communities and the health workforce, extending to both providers and care-seeking women. Informants had witnessed mistreatment of women seeking care due to abortion complications, through deliberate care delays and denial of pain medication.

KEY CONCLUSION AND IMPLICATIONS FOR PRACTICE: Midwives in PAC were dedicated to saving women's lives; however, conflicting morality and duty and poor working conditions impeded quality of care. Enabling midwives to provide good quality care includes increasing the patient-midwife ratio and ensuring essential resources are available. Additionally, efforts that de-stigmatise abortion and promote accountability are needed. Implementation of policies on respectful post-abortion care could aid in ensuring all women are treated with respect.

Nyckelord
Midwifery, Post-abortion care, Quality of care, Stigma, Uganda
Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
Hälsa och välfärd
Identifikatorer
urn:nbn:se:du-30546 (URN)10.1016/j.midw.2019.06.004 (DOI)000478779100010 ()31255911 (PubMedID)2-s2.0-85067848976 (Scopus ID)
Tillgänglig från: 2019-07-03 Skapad: 2019-07-03 Senast uppdaterad: 2019-08-15Bibliografiskt granskad
Osman, F., Flacking, R., Klingberg-Allvin, M. & Schön, U.-K. (2019). Qualitative study showed that a culturally tailored parenting programme improved the confidence and skills of Somali immigrants. Acta Paediatrica, 108(8), 1482-1490
Öppna denna publikation i ny flik eller fönster >>Qualitative study showed that a culturally tailored parenting programme improved the confidence and skills of Somali immigrants
2019 (Engelska)Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, nr 8, s. 1482-1490Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

AIM: Parenting programmes tailored to immigrant parents have been reported to improve the mental health of the children and parents, as well as parents' sense of competence in parenting. However, research on parents' experiences of programmes tailored to their needs is scarce. This qualitative study aimed to describe Somali parents' experiences of how a culturally sensitive programme affected their parenting.

METHODS: The study was conducted in a middle-sized city in Sweden in 2015. Data were collected through semi-structured interviews with 50 participants two months after they took part in a parenting support programme. Inductive and deductive qualitative content analyses were used.

RESULTS: A light has been shed was a metaphor that emerged from the analysis and that captured the knowledge the parents gained from the parenting system in Sweden. Parents gained confidence in their parenting role and became emotionally aware of their child's social and emotional needs and how to respond to them. Holding the sessions in the participant's native language was important for the parents' participation and acceptance of the programme.

CONCLUSION: Parenting programmes should be tailored to the specific needs of the participants and cultural sensitivity should be factored into programmes to attract immigrant parents. This article is protected by copyright. All rights reserved.

Nyckelord
cultural sensitivity, effective parenting, family relationships, immigrants, parenting programmes
Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
Hälsa och välfärd
Identifikatorer
urn:nbn:se:du-29761 (URN)10.1111/apa.14788 (DOI)000474935600019 ()30896042 (PubMedID)2-s2.0-85064519588 (Scopus ID)
Tillgänglig från: 2019-03-26 Skapad: 2019-03-26 Senast uppdaterad: 2019-07-29Bibliografiskt granskad
Klingberg-Allvin, M., Atuhairwe, S., Cleeve, A., Byamugisha, J. K., Larsson, E. C., Makenzius, M., . . . Gemzell-Danielsson, K. (2018). Co-creation to scale up provision of simplified high-quality comprehensive abortion care in East Central and Southern Africa. Global Health Action, 11(1), Article ID 1490106.
Öppna denna publikation i ny flik eller fönster >>Co-creation to scale up provision of simplified high-quality comprehensive abortion care in East Central and Southern Africa
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2018 (Engelska)Ingår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 11, nr 1, artikel-id 1490106Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Universal access to comprehensive abortion care (CAC) is a reproductive right and is essential to reduce preventable maternal mortality and morbidity. In East Africa, abortion rates are consistently high, and the vast majority of all abortions are unsafe, significantly contributing to unnecessary mortality and morbidity. The current debate article reflects and summarises key action points required to continue to speed the implementation of and expand access to CAC in the East, Central, and Southern African (ECSA) health community. To ensure universal access to quality CAC, a regional platform could facilitate the sharing of best practices and successful examples from the region, which would help to visualise opportunities. Such a platform could also identify innovative ways to secure women's access to quality care within legally restrictive environments and would provide information and capacity building through the sharing of recent scientific evidence, guidelines, and training programmes aimed at increasing women's access to CAC at the lowest effective level in the healthcare system. This type of infrastructure for exchanging information and developing co-creation could be crucial to advancing the Sustainable Development Goals 2030 agenda.

Nyckelord
Central, Eastern, Northern Africa, Unsafe abortions, maternal mortality
Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
Hälsa och välfärd
Identifikatorer
urn:nbn:se:du-28137 (URN)10.1080/16549716.2018.1490106 (DOI)000437262000001 ()29972099 (PubMedID)
Tillgänglig från: 2018-07-09 Skapad: 2018-07-09 Senast uppdaterad: 2018-07-19Bibliografiskt granskad
Makenzius, M., Faxelid, E., Gemzell-Danielsson, K., Odero, T. M., Klingberg-Allvin, M. & Oguttu, M. (2018). Contraceptive uptake in post abortion care-Secondary outcomes from a randomised controlled trial, Kisumu, Kenya.. PLoS ONE, 13(8), Article ID e0201214.
Öppna denna publikation i ny flik eller fönster >>Contraceptive uptake in post abortion care-Secondary outcomes from a randomised controlled trial, Kisumu, Kenya.
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2018 (Engelska)Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, nr 8, artikel-id e0201214Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

AIM: The aim was to explore contraceptive uptake, associated factors and satisfaction among post abortion-care (PAC) seeking women in Kenya. Due to unsafe abortions, almost 120 000 Kenyan women received PAC in 2012, and of these women, 70% did not use contraception before pregnancy.

METHODS: This study was nested in a larger randomised controlled trial, where 859 women sought PAC at two public hospitals in Kisumu, in June 2013-May 2016. The women were randomly assigned to a midwife or a physician for PAC, including contraceptive counselling, and followed up at 7-10 days and three months. Associated factors for contraceptive uptake were analysed with binary logistic regression, and contraceptive method choice, adherence and satisfaction level were examined by descriptive statistics, using IBM SPSS Statistics for Windows, Version 22.0.

RESULTS: Out of the 810 PAC-seeking women, 76% (n = 609) accepted the use of contraception. Age groups of 21-25 (OR: 2.35; p < 0.029) and 26-30 (OR: 2.22; p < 0.038), and previous experience of 1-2 gravidities (OR 1.939; p = 0.018) were independent factors associated with the up-take. Methods used: injections 39% (n = 236); pills 27% (n = 166); condoms 25% (n = 151); implant 7% (n = 45) and intrauterine device (IUD) 1% (n = 8). At 3-month follow-up of the women (470/609; 77%), 354 (75%) women still used contraception, and most (n = 332; 94%) were satisfied with the method. Reasons for discontinuation were side-effects (n = 44; 39%), partner refusal (n = 27; 24%), planned pregnancy (n = 27; 24%) and lack of resupplies (n = 15; 13%).

CONCLUSIONS: PAC-seeking women seem highly motivated to use contraceptives, yet a quarter decline the use, and at 3-month follow-up a further quarter among the users had discontinued. Implant, IUD and permanent method are rarely used. Strategies to improve contraceptive counselling, particularly to adolescent girls, and to increase access to a wide range of methods, as well as provider training and supervision may help to improve contraceptive acceptance and compliance among PAC-seeking women in Kisumu, Kenya.

Nationell ämneskategori
Hälsovetenskaper
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Identifikatorer
urn:nbn:se:du-28308 (URN)10.1371/journal.pone.0201214 (DOI)000441308500014 ()30096148 (PubMedID)2-s2.0-85052335851 (Scopus ID)
Tillgänglig från: 2018-08-14 Skapad: 2018-08-14 Senast uppdaterad: 2018-09-10Bibliografiskt granskad
Rehnström Loi, U., Lindgren, M., Faxelid, E., Oguttu, M. & Klingberg-Allvin, M. (2018). Decision-making preceding induced abortion: a qualitative study of women’s experiences in Kisumu, Kenya. Reproductive Health, 15, Article ID 166.
Öppna denna publikation i ny flik eller fönster >>Decision-making preceding induced abortion: a qualitative study of women’s experiences in Kisumu, Kenya
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2018 (Engelska)Ingår i: Reproductive Health, ISSN 1742-4755, E-ISSN 1742-4755, Vol. 15, artikel-id 166Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background

Unwanted pregnancies and unsafe abortions are prevalent in regions where women and adolescent girls have unmet contraceptive needs. Globally, about 25 million unsafe abortions take place every year. In countries with restrictive abortion laws, safe abortion care is not always accessible. In Kenya, the high unwanted pregnancy rate resulting in unsafe abortions is a serious public health issue. Gaps exist in knowledge regarding women’s decision-making processes in relation to induced abortions in Kenya. Decision-making is a fundamental factor for consideration when planning and implementing contraceptive services. This study explored decision-making processes preceding induced abortion among women with unwanted pregnancy in Kisumu, Kenya.

Methods

Individual face-to-face in-depth interviews were conducted with nine women aged 19–32 years old. Women who had experienced induced abortion were recruited after receiving post-abortion care at the Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) or Kisumu East District Hospital (KDH) in Kisumu, Kenya. In total, 15 in-depth interviews using open-ended questions were conducted. All interviews were tape-recorded, transcribed and coded manually using inductive content analysis.

Results

Respondents described their own experiences regarding decision-making preceding induced abortion. This study shows that the main reasons for induced abortion were socio-economic stress and a lack of support from the male partner. In addition, deviance from family expectations and gender-based norms highly influenced the decision to have an abortion among the interviewed women. The principal decision maker was often the male partner who pressed for the termination of the pregnancy indirectly by declining his financial or social responsibilities or directly by demanding termination. In some cases, the male partner controlled decision-making by arranging an unsafe abortion without the woman’s consent. Strategic choices regarding whom to confide in were employed as protection against abortion stigma. This contributed to a culture of silence around abortion and unwanted pregnancy, a factor that made women more vulnerable to complications.

Conclusions

The findings suggest that financial, social and gender-based dependencies influence women’s agency and perceived options in decision-making regarding abortion.

Nyckelord
Abortion, Decision-making, Qualitative methodology, In-depth interviews, Kenya
Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
Hälsa och välfärd
Identifikatorer
urn:nbn:se:du-28653 (URN)10.1186/s12978-018-0612-6 (DOI)000446381200002 ()30285768 (PubMedID)2-s2.0-85054469473 (Scopus ID)
Forskningsfinansiär
Vetenskapsrådet
Anmärkning

Open Access APC beslut 20/2018

Tillgänglig från: 2018-10-04 Skapad: 2018-10-04 Senast uppdaterad: 2019-01-03Bibliografiskt granskad
Abdillahi, H. A., Hassan, K. A., Kiruja, J., Osman, F., Egal, J. A., Klingberg-Allvin, M. & Erlandsson, K. (2017). A mixed-methods study of maternal near miss and death after emergency cesarean delivery at a referral hospital in Somaliland. International Journal of Gynecology & Obstetrics, 138(1), 119-124
Öppna denna publikation i ny flik eller fönster >>A mixed-methods study of maternal near miss and death after emergency cesarean delivery at a referral hospital in Somaliland
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2017 (Engelska)Ingår i: International Journal of Gynecology & Obstetrics, ISSN 0020-7292, E-ISSN 1879-3479, Vol. 138, nr 1, s. 119-124Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVE: To explore maternal near miss and death after emergency cesarean delivery in Somaliland, including the impact of the prerequisite for family consent.

METHODS: A facility-based, mixed-methods study was conducted to assess all maternal near misses and deaths recorded at a referral hospital that provided services to women from all regions of Somaliland. The data sources comprised a quantitative prospective cross-sectional study using the WHO near-miss tool (performed from August 1 to December 31, 2015) and qualitative interviews with 17 healthcare providers working at the referral hospital who were in direct contact with the women in labor (performed from January 15 to March 15, 2015).

RESULTS: Of the 138 maternal near misses and deaths recorded, 50 (36%) were associated with emergency cesarean delivery. The most frequent maternal complication was severe pre-eclampsia (n=17; 34%), and the most frequent underlying causes were hypertensive disorders (n=31; 62%) and obstetric hemorrhage (n=15; 30%). Healthcare providers were often prevented from performing emergency cesarean delivery until the required consent had been received from the woman's extended family.

CONCLUSION: Maternity care in Somaliland must be improved, and the issue of legal authority for consent examined, to ensure both safe and timely provision of emergency cesarean delivery. This article is protected by copyright. All rights reserved.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2017
Nyckelord
Cesarean delivery, Consent, Maternal death, Near miss, Somaliland
Nationell ämneskategori
Omvårdnad
Forskningsämne
Hälsa och välfärd
Identifikatorer
urn:nbn:se:du-24701 (URN)10.1002/ijgo.12176 (DOI)000405092600021 ()28391614 (PubMedID)
Forskningsfinansiär
Sida - Styrelsen för internationellt utvecklingssamarbete
Tillgänglig från: 2017-04-11 Skapad: 2017-04-11 Senast uppdaterad: 2017-10-23Bibliografiskt granskad
Organisationer
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0002-8947-2949

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