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Maternal near-miss and death incidences – Frequencies, causes and the referral chain in Somaliland: A pilot study using the WHO near-miss approach
Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.ORCID-id: 0000-0002-0038-9402
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2017 (Engelska)Ingår i: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 12, s. 30-36Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background Somaliland is a self-declared country with a population of 3.5 million. Most of its population reside in rural areas. The objective of this pilot near-miss study was to monitor the frequency and causes of maternal near-miss and deaths and the referral chain for women to access Skilled Birth Attendants (SBA). Method: A facility-based study of all maternal near-miss and mortality cases over 5 months using the WHO near-miss tool in a main referral hospital. Reasons for bypassing the Antenatal Care facility (ANC) and late arrival to the referral hospital were investigated through verbal autopsy. Results: One hundred and thirty-eight (138) women with severe maternal complications were identified: 120 maternal near-miss, 18 maternal deaths. There were more near-miss cases on arrival (74.2%) compared with events that developed inside the hospital (25.8%). Likewise, there were more maternal deaths (77.8%) on arrival than was the case during hospitalization (22.2%). The most common mode of referral among maternal near-miss events was family referrals (66.7%). Of 18 maternal deaths, 15 were family referrals. Reasons for bypassing ANC were as follows: lack of confidence in the service provided; lack of financial resources; and lack of time to visit ANC. Reasons for late arrival to the referral hospital were as follows: lack of knowledge and transportation; and poor communication. Conclusion and clinical implication: To increase the utilization of ANC might indirectly lower the number of near-miss and death events. Collaboration between ANC staff and referral hospital staff and a more comprehensive near-miss project are proposed. © 2017 Elsevier B.V.

Ort, förlag, år, upplaga, sidor
2017. Vol. 12, s. 30-36
Nyckelord [en]
Maternal death, Maternal near-miss, Referral chain, Somaliland
Nationell ämneskategori
Hälsovetenskaper
Forskningsämne
Hälsa och välfärd
Identifikatorer
URN: urn:nbn:se:du-24581DOI: 10.1016/j.srhc.2017.02.003ISI: 000401884100006PubMedID: 28477929Scopus ID: 2-s2.0-85013803837OAI: oai:DiVA.org:du-24581DiVA, id: diva2:1081232
Tillgänglig från: 2017-03-13 Skapad: 2017-03-13 Senast uppdaterad: 2017-06-15Bibliografiskt granskad

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Osman, FatumoKlingberg-Allvin, MarieErlandsson, Kerstin

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