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The impact of training traditional birth attendants on the utilisation of maternal health services.

Mathur, H N; Damodar; Sharma, P N; Jain, T P
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /06/1979 EN
Relevância na Pesquisa
46.45%
The impact of training traditional birth attendants (TBAs) on the utilisation of maternal health services at a rural health training centre in India has been studied. Records of the utilisation of the services for two periods of six months each (one before training and one after) have been analysed. A marked improvement in the registration of antenatal cases at an earlier date in pregnancy has been observed. The average number of visits to antenatal clinics, the immunisation against tetanus, and the presence of trained personnel at the time of delivery all showed considerable improvement after the local TBAs had been trained and motivated. The differences observed in the two series were statistically significant.

Referrals by traditional birth attendants in northeast Brazil.

Janowitz, B; Wallace, S; Araujo, G; Araujo, L
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /07/1985 EN
Relevância na Pesquisa
46.45%
Between October 1980 and July 1981, 1,878 women were attended by traditional birth attendants (TBAs) at four obstetric units in rural areas surrounding the city of Fortaleza in Northeast Brazil. Of these women, 232 (12.4 per cent) were referred to a hospital in Fortaleza for delivery. The most important indicators for referral to hospital were: presence of an antenatal problem, complication of labor, or malpresentation. Based on record review, 65 referred women with none of these conditions were classified as low risk and 42 women not referred were classified as high risk (at least one such condition present). Of 1,878 deliveries, 32 (17 per 1,000) terminated as fetal deaths, and 12 infants died before discharge from hospital or obstetric unit (six per 1,000). The death rate was much higher for the high-risk cases (156 per 1,000 referrals, 95 for nonreferrals). Although some women may have been inappropriately referred while others who should have been were not referred, the system of referral has allowed TBAs to attend uncomplicated deliveries and to refer women with complications.

Recognizing illicit drug use by pregnant women: reports from Oregon birth attendants.

Slutsker, L; Smith, R; Higginson, G; Fleming, D
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /01/1993 EN
Relevância na Pesquisa
46.6%
OBJECTIVES. This study was undertaken to determine the prevalence of recognized prenatal illicit substance abuse and the characteristics of women being identified as illicit drug users in a statewide population-based cohort. METHODS. During a 1-month period, birth attendants of all singleton births in Oregon (n = 3200) were surveyed regarding their knowledge of prenatal illicit drug use by women who gave birth. Birth certificates were linked to surveys after removal of personal identifiers. RESULTS. Illicit drug use was recognized in 5.2% of delivering women. Nearly half had used cocaine, methamphetamine, or heroin. Recognized users were significantly more likely than nonusers to be unwed and to have used tobacco or alcohol, have received inadequate prenatal care, and have public assistance as a source of payment. Drug use was recognized twice as frequently by practitioners who routinely questioned their patients about it compared with those who relied on clinical judgment or the occurrence of complications during pregnancy. Birth certificate reporting identified only 41% of recognized users. CONCLUSIONS. Oregon practitioners are identifying seven times as many drug-using women as can be accommodated by available treatment programs for this population. Increased efforts are needed to ensure the adequacy of resources necessary to cope with the problem as already recognized.

Management of childhood pneumonia by traditional birth attendants. The SEARCH Team.

Bang, A. T.; Bang, R. A.; Sontakke, P. G.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica
Publicado em //1994 EN
Relevância na Pesquisa
46.45%
In a field trial in Gadchiroli, India, we trained 30 paramedical workers (PMWs), 25 village health workers (VHWs) and 86 traditional birth attendants (TBAs) from 58 villages to diagnose childhood pneumonia and treat it with sulfamethoxazole+trimethoprim. Continued training, the development of a breath counter, and educative supervision progressively reduced errors in case management made by the TBAs. Over the 3.5-year period 1988-91, 2568 attacks of childhood pneumonia were managed and the case fatality rate was 0.9%, compared with a rate of 13.5% in the control area. The case fatality rates for the three types of worker were similar. The TBAs were superior to the other workers in terms of their availability, outreach, access to neonates, and cost. Satisfaction with the VHWs, and PMWs was expressed by 85%, 69% and 18% of users, respectively. In the intervention area the mortality rate attributable to pneumonia among neonates declined by 44% (P < 0.01) while the total neonatal mortality fell by 20%, presumably because of the involvement of TBAs in the control of acute respiratory infections (ARI). If adequately supported by the health system, TBAs can successfully manage childhood pneumonia in villages at the lowest possible cost and with a high degree of community acceptance. TBAs and VHWs are the most suitable community-based health workers for ARI control programmes in developing countries.

Characteristics of traditional birth attendants and their beliefs and practices in the Offot Clan, Nigeria.

Itina, S. M.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica
Publicado em //1997 EN
Relevância na Pesquisa
46.45%
This article presents the findings of a survey of a group of 52 traditional birth attendants (TBAs) in a clan in south-eastern Nigeria. The purpose of the study was to develop a database from which to design an effective programme for TBAs in the safe delivery and early referral of women with complications to hospital. The study showed that the majority of TBAs were illiterate and had no previous experience or training, even informal training, when they took on the TBA role. Ignorance about maternal complications during childbirth and the appropriate treatment was evident for most of the group. A small number of the group relied solely on divine revelation for guidance in the management of child-bearing women. The results of the survey clearly showed that educational programmes for TBAs and better integration into the health care system are essential for lowering maternal mortality and morbidity rates in areas where most mothers are not open to nor have access to professional care in childbirth.

Practices of Rural Egyptian Birth Attendants During the Antenatal, Intrapartum and Early Neonatal Periods

Darmstadt, Gary L.; Hussein, Mohamed Hassan; Winch, Peter J.; Haws, Rachel A.; Gipson, Reginald; Santosham, Mathuram
Fonte: International Centre for Diarrhoeal Disease Research, Bangladesh Publicador: International Centre for Diarrhoeal Disease Research, Bangladesh
Tipo: Artigo de Revista Científica
Publicado em /03/2008 EN
Relevância na Pesquisa
46.87%
Neonatal deaths account for almost two-thirds of infant mortality worldwide; most deaths are preventable. Two-thirds of neonatal deaths occur during the first week of life, usually at home. While previous Egyptian studies have identified provider practices contributing to maternal mortality, none has focused on neonatal care. A survey of reported practices of birth attendants was administered. Chi-square tests were used for measuring the statistical significance of inter-regional differences. In total, 217 recently-delivered mothers in rural areas of three governorates were interviewed about antenatal, intrapartum and postnatal care they received. This study identified antenatal advice of birth attendants to mothers about neonatal care and routine intrapartum and postpartum practices. While mothers usually received antenatal care from physicians, traditional birth attendants (dayas) conducted most deliveries. Advice was rare, except for breastfeeding. Routine practices included hand-washing by attendants, sterile cord-cutting, prompt wrapping of newborns, and postnatal home visits. Suboptimal practices included lack of disinfection of delivery instruments, unhygienic cord care, lack of weighing of newborns, and lack of administration of eye prophylaxis or vitamin K. One-third of complicated deliveries occurred at home...

Delivery Practices of Traditional Birth Attendants in Dhaka Slums, Bangladesh

Fronczak, N.; Arifeen, S.E.; Moran, A.C.; Caulfield, L.E.; Baqui, A.H.
Fonte: International Centre for Diarrhoeal Disease Research, Bangladesh Publicador: International Centre for Diarrhoeal Disease Research, Bangladesh
Tipo: Artigo de Revista Científica
Publicado em /12/2007 EN
Relevância na Pesquisa
46.86%
This paper describes associations among delivery-location, training of birth attendants, birthing practices, and early postpartum morbidity in women in slum areas of Dhaka, Bangladesh. During November 1993–May 1995, data on delivery-location, training of birth attendants, birthing practices, delivery-related complications, and postpartum morbidity were collected through interviews with 1,506 women, 489 home-based birth attendants, and audits in 20 facilities where the women from this study gave birth. Associations among maternal characteristics, birth practices, delivery-location, and early postpartum morbidity were specifically explored. Self-reported postpartum morbidity was associated with maternal characteristics, delivery-related complications, and some birthing practices. Dais with more experience were more likely to use potentially-harmful birthing practices which increased the risk of postpartum morbidity among women with births at home. Postpartum morbidity did not differ by birth-location. Safe motherhood programmes must develop effective strategies to discourage potentially-harmful home-based delivery practices demonstrated to contribute to morbidity.

Where There Are (Few) Skilled Birth Attendants

Prata, Ndola; Passano, Paige; Rowen, Tami; Bell, Suzanne; Walsh, Julia; Potts, Malcolm
Fonte: International Centre for Diarrhoeal Disease Research, Bangladesh Publicador: International Centre for Diarrhoeal Disease Research, Bangladesh
Tipo: Artigo de Revista Científica
Publicado em /04/2011 EN
Relevância na Pesquisa
46.9%
Recent efforts to reduce maternal mortality in developing countries have focused primarily on two long-term aims: training and deploying skilled birth attendants and upgrading emergency obstetric care facilities. Given the future population-level benefits, strengthening of health systems makes excellent strategic sense but it does not address the immediate safe-delivery needs of the estimated 45 million women who are likely to deliver at home, without a skilled birth attendant. There are currently 28 countries from four major regions in which fewer than half of all births are attended by skilled birth attendants. Sixty-nine percent of maternal deaths in these four regions can be attributed to these 28 countries, despite the fact that these countries only constitute 34% of the total population in these regions. Trends documenting the change in the proportion of births accompanied by a skilled attendant in these 28 countries over the last 15-20 years offer no indication that adequate change is imminent. To rapidly reduce maternal mortality in regions where births in the home without skilled birth attendants are common, governments and community-based organizations could implement a cost-effective, complementary strategy involving health workers who are likely to be present when births in the home take place. Training community-based birth attendants in primary and secondary prevention technologies (e.g. misoprostol...

Definitions and roles of a skilled birth attendant: a mapping exercise from four South-Asian countries

Utz, Bettina; Siddiqui, Ghazna; Adegoke, Adetoro; Broek, Nynke Van Den
Fonte: John Wiley & Sons Publicador: John Wiley & Sons
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.78%
Objective. To identify which cadres of healthcare providers are considered to be skilled birth attendants in South Asia, which of the signal functions of emergency obstetric care each cadre is reported to provide and whether this is included in their training and legislation. Design. Cross-sectional, descriptive study. Setting. Bangladesh, India, Nepal and Pakistan. Sample. Thirty-three key informants involved in training, regulation, recruitment and deployment of healthcare providers. Methods. Between November 2011 and March 2012, structured questionnaires were sent out to key informants by email followed up by face-to-face or telephone interviews. Main outcome measures. Mapping of definitions and roles of healthcare providers in four South Asian countries to assess which cadres are skilled birth attendants. Results. Cadres of healthcare providers expected to provide skilled birth attendance differ across countries. Although most identified cadres administer parenteral antibiotics, oxytocics and perform newborn resuscitation; administration of anticonvulsants varies by country. Manual removal of the placenta, removal of retained products of conception and assisted vaginal delivery are not provided by all cadres expected to provide skilled birth attendance. Conclusion. Key signal functions of emergency obstetric care are often provided by medical doctors only. Provision of such potentially life-saving interventions by more healthcare provider cadres expected to function as skilled birth attendants can save lives. Ensuring better training and legislation are in place for this is crucial.

"...and then she died" : Indonesia Maternal Health Assessment

World Bank
Fonte: World Bank Publicador: World Bank
Relevância na Pesquisa
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Maternal health remains one of the top priorities of the Government of Indonesia (GoI) and the Ministry of Health (MoH) because reductions in maternal mortality have been slows. The current Maternal Mortality Ratio (MMR) for Indonesia is 228 but with existing programs and interventions the government does not believe it will be able to achieve its stated millennium development goal of 102 maternal deaths per 100,000 live births by 2015. There are positive trends in an increased use of skilled birth attendants, almost universal access to some level of antenatal care and continued use of family planning but these are not enough to stem the tide of maternal death. Interventions by the skilled birth attendants in many cases are not in line with existing standards and prove to be ineffective in trying to address the emergence of complications. Antenatal care is important, but it is not where gains in decreased mortality will be obtained. The continued use of traditional birth attendants (TBA) and delivering at home are contributory factors to maternal mortality in Indonesia. In collecting data from verbal autopsies in three districts...

How can current NGO-delivered health services aimed at reducing the incidence of maternal mortality in PNG be improved? Discuss in the context of Millennium Development Goal 5.

Teong, Samantha
Fonte: Universidade Nacional da Austrália Publicador: Universidade Nacional da Austrália
Tipo: Relatório
Relevância na Pesquisa
46.53%
The Millennium Development Goals (MDG) were developed by the United Nations (UN) in 2000 with the aim of reducing world poverty by 2015. In particular, MDG 5, 'Improved Maternal Health', is a concern for Papua New Guinea (PNG). Despite substantial foreign aid from Australia in the last decade, PNG is still a far way off from achieving MDG 5, suggesting that merely increasing funding is not a solution. Indeed, the situation in PNG has deteriorated, with its maternal mortality ratio almost doubling from 370 maternal deaths per 100,000 live births in 1996 to 733 per 100,000 in 2006.1 Attention must be paid to maternal health services by non-government organisations (in this case, Australian, Papua New Guinean or partnered projects) as they are independent actors who can deliver aid in places and ways that governments cannot. This report focuses on NGOs as their efforts receive less public attention when compared to more extensive government aid reviews. The need for Australia to review its NGO maternal aid efforts in helping PNG is highlighted by the preliminary fact that the MDGs are UN targets which Australia as a UN member is obliged to achieve. Clearly, the failure of current efforts to improve maternal health in PNG is the primary motivation for review. However other reasons include Australia's traditional duty as PNG's closest neighbour and largest foreign aid donor. Furthermore...

A child's first right: birth registration and its role in combating child trafficking and the spread of HIV/AIDS

van der Rijt, Tess
Fonte: Universidade Nacional da Austrália Publicador: Universidade Nacional da Austrália
Tipo: Relatório
Relevância na Pesquisa
46.47%
Birth registration is a fundamental right that facilitates access to other rights. Officially, an unregistered child does not exist and as such they do not have an official name or identity. A child’s access to basic services such as health and education is denied and they are more vulnerable to abuse and exploitation. “7/ is a fact that if we could assist countries in developing models and proposals... in which children could be registered at birth, then it would be far less likely that they would be able to be trafficked... Children are trafficked... primarily into the sex industry, where they then become victims of HIV/AIDS... Instead of being treated, these children are thrown out on the street... they are treated as illegal immigrants in the country where they have been violated. ” This report aims to assist countries in developing models and proposals in order to ensure registration of all children at birth. The report examines four birth registration systems from different regions of the world. The established birth registration systems in Australia, Canada and the United Kingdom (UK), all with high registration rates, are cross-examined and key principles are delineated. The objective is to understand the core principles of the three birth registration systems...

Transition to Skilled Birth Attendance: Is There a Future Role for Trained Traditional Birth Attendants?

Sibley, Lynn M.; Sipe, Theresa Ann
Fonte: International Centre for Diarrhoeal Disease Research, Bangladesh Publicador: International Centre for Diarrhoeal Disease Research, Bangladesh
Tipo: Artigo de Revista Científica
Publicado em /12/2006 EN
Relevância na Pesquisa
46.63%
A brief history of training of traditional birth attendants (TBAs), summary of evidence for effectiveness of TBA training, and consideration of the future role of trained TBAs in an environment that emphasizes transition to skilled birth attendance are provided. Evidence of the effectiveness of TBA training, based on 60 studies and standard meta-analytic procedures, includes moderate-to-large improvements in behaviours of TBAs relating to selected intrapartum and postnatal care practices, small significant increases in women's use of antenatal care and emergency obstetric care, and small significant decreases in perinatal mortality and neonatal mortality due to birth asphyxia and pneumonia. Such findings are consistent with the historical focus of TBA training on extending the reach of primary healthcare and a few programmes that have included home-based management of complications of births and the newborns, such as birth asphyxia and pneumonia. Evidence suggests that, in settings characterized by high mortality and weak health systems, trained TBAs can contribute to the Millennium Development Goal 4—a two-thirds reduction in the rate of mortality of children aged less than 14 years by 2015—through participation in key evidence-based interventions.

Using the Community-Based Health Planning and Services Program to Promote Skilled Delivery in Rural Ghana; Socio-Demographic Factors that Influence Women Utilization of Skilled Attendants at Birth in Northern Ghana

Sakeah, Evelyn; Doctor, Henry V.; McCloskey, Lois; Bernstein, Judith; Yeboah-Antwi, Kojo; Mills, Samuel
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Journal Article; Publications & Research :: Journal Article; Publications & Research
EN_US
Relevância na Pesquisa
56.74%
The burden of maternal mortality in sub-Saharan Africa is enormous. In Ghana the maternal mortality ratio was 350 per 100,000 live births in 2010. Skilled birth attendance has been shown to reduce maternal deaths and disabilities, yet in 2010 only 68% of mothers in Ghana gave birth with skilled birth attendants. In 2005, the Ghana Health Service piloted an enhancement of its Community-Based Health Planning and Services (CHPS) program, training Community Health Officers (CHOs) as midwives, to address the gap in skilled attendance in rural Upper East Region (UER). The study determined the extent to which CHO-midwives skilled delivery program achieved its desired outcomes in UER among birthing women.

Condições de trabalho de parteiras tradicionais: algumas características no contexto domiciliar rural; Working conditions of traditional birth attendants: some characteristics at home and rural context

Bessa, Lucineide Frota
Fonte: Universidade de São Paulo. Escola de Enfermagem Publicador: Universidade de São Paulo. Escola de Enfermagem
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; Formato: application/pdf
Publicado em 01/09/1999 POR
Relevância na Pesquisa
46.71%
Este é um estudo de abordagem qualitativa e dialética, que tem como objetivo analisar as condições de trabalho da parteira tradicional, numa perspectiva de trabalho reprodutivo e, portanto, desvalorizado economicamente. A análise foi construída tendo como categoria central o trabalho à partir de pressupostos marxista e feminista. Os resultados obtidos nos permitem, afirmar que as parteiras realizam seu trabalho em precárias condições materiais, financeiras, relativas ao transporte e ao acesso e, ainda, ao ambiente de trabalho. A análise dessa prática nos proporcionou apresentar uma discussão em torno de algumas características do trabalho da parteira tradicional, o qual se caracteriza como trabalho reprodutivo, desvalorizado economicamente, informal, autônomo e eminentemente feminino. Se configura, ainda, como uma prática social de saúde popular legitimada pela comunidade. Na prática obstétrica domiciliar rural evidenciamos relações desiguais, à medida que homens e mulheres realizam atividades diferentes numa mesma ocupação, cabendo às mulheres as tarefas que reproduzem o papel feminino.; This is a study of qualitative and dialectical approach, which subject is to analize the working conditions of the traditional birth attendants...

Increasing the use of skilled health personnel where traditional birth attendants were providers of childbirth care: a systematic review

Vieira, Claudia; Portela, Anayda; Miller, Tina; Coast, Ernestina; Leone, Tiziana; Marston, Cicley
Fonte: PLoS ONE Publicador: PLoS ONE
Tipo: Article; PeerReviewed Formato: application/pdf
Publicado em /10/2012 EN; EN
Relevância na Pesquisa
46.66%
Background: Improved access to skilled health personnel for childbirth is a priority strategy to improve maternal health. This study investigates interventions to achieve this where traditional birth attendants were providers of childbirth care and asks: what has been done and what has worked? Methods and Findings: We systematically reviewed published and unpublished literature, searching 26 databases and contacting experts to find relevant studies. We included references from all time periods and locations. 132 items from 41 countries met our inclusion criteria and are included in an inventory; six were intervention evaluations of high or moderate quality which we further analysed. Four studies report on interventions to deploy midwives closer to communities: two studies in Indonesia reported an increase in use of skilled health personnel; another Indonesian study showed increased uptake of caesarean sections as midwives per population increased; one study in Bangladesh reported decreased risk of maternal death. Two studies report on interventions to address financial barriers: one in Bangladesh reported an increase in use of skilled health personnel where financial barriers for users were addressed and incentives were given to skilled care providers; another in Peru reported that use of emergency obstetric care increased by subsidies for preventive and maternity care...

Male circumcision as strategy for HIV prevention and sexually transmitted diseases: the potential role of traditional birth attendants in neonatal male circumcision

Dini,Catia
Fonte: Istituto Superiore di Sanità Publicador: Istituto Superiore di Sanità
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2010 EN
Relevância na Pesquisa
66.71%
In developing countries, it would be advisable to give priority to human immunodeficiency virus (HIV) prevention strategies, because of the high mortality caused by the rapid spread of the pandemic. Furthermore, HIV prevention could contribute to the mitigation of tuberculosis (TB) propagation, which is tightly correlated to acquired immune deficiency syndrome (AIDS). As demonstrated, male circumcision (MC) confers protection against HIV and sexually transmitted diseases (STD). The suggested strategy considers the neonatal MC advantageous, since it is safer, feasible, culturally more acceptable and less costly than adult MC. This approach is based on the assumption that, if newborn males are circumcised, within the next 15-20 years the sexually active population will be almost entirely circumcised and, consequently, the HIV transmission will be reduced. The employment of retrained traditional birth attendants is considered in order to implement the MC after the child birth and to facilitate its acceptance in those contexts where it is not traditionally performed.

A prefilled injection device for outreach tetanus immunization by Bolivian traditional birth attendants

Quiroga,Rosario; Halkyer,Percy; Gil,Fernando; Nelson,Carib; Kristensen,Debra
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/07/1998 EN
Relevância na Pesquisa
46.87%
This study evaluated the performance, acceptability, and appropriateness of a new, single-use, prefilled injection device called UniJect™ for an outreach immunization application.6 Between April and June 1995, UniJect devices were used by 36 traditional birth attendants to administer tetanus toxoid injections to 2 240 pregnant women during routine, antenatal home visits in the Northern, Ichilos, and Warnes Districts of Santa Cruz, Bolivia. Because tetanus toxoid is relatively heat stable, the traditional birth attendants were able to keep the tetanus toxoid-filled UniJect devices in their homes for up to one month without refrigeration. The devices were stored, transported, and disposed of in an outreach carrier designed to reduce the risks of improper handling and disposal. Data were collected from injection recipients, traditional birth attendants, and supervisors via observation, questionnaires, and post-study interviews. The performance of the UniJect device and its acceptability among all groups was very high. The traditional birth attendants used UniJect properly and safely; there were no reports or observations of device misuse, reuse, or needle-stick. Advantages cited included the fact that the device required no assembly...

Providing skilled birth attendants and emergency obstetric care to the poor through partnership with private sector obstetricians in Gujarat, India

Singh,Amarjit; Mavalankar,Dileep V; Bhat,Ramesh; Desai,Ajesh; Patel,SR; Singh,Prabal V; Singh,Neelu
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2009 EN
Relevância na Pesquisa
46.66%
PROBLEM: India has the world's largest number of maternal deaths estimated at 117 000 per year. Past efforts to provide skilled birth attendants and emergency obstetric care in rural areas have not succeeded because obstetricians are not willing to be posted in government hospitals at subdistrict level. APPROACH: We have documented an innovative public-private partnership scheme between the Government of Gujarat, in India, and private obstetricians practising in rural areas to provide delivery care to poor women. LOCAL SETTING: In April 2007, the majority of poor women delivered their babies at home without skilled care. RELEVANT CHANGES: More than 800 obstetricians joined the scheme and more than 176 000 poor women delivered in private facilities. We estimate that the coverage of deliveries among poor women under the scheme increased from 27% to 53% between April and October 2007. The programme is considered very successful and shows that these types of social health insurance programmes can be managed by the state health department without help from any insurance company or international donor. LESSONS LEARNED: At least in some areas of India, it is possible to develop large-scale partnerships with the private sector to provide skilled birth attendants and emergency obstetric care to poor women at a relatively small cost. Poor women will take up the benefit of skilled delivery care rapidly...

Birth attendants as perinatal verbal autopsy respondents in low-and middle-income countries: a viable alternative?

Engmann,C; Garces,A; Jehan,I; Ditekemena,J; Phiri,M; Thorsten,V; Mazariegos,M; Chomba,E; Pasha,O; Tshefu,A; Wallace,D; McClure,EM; Goldenberg,RL; Carlo,WA; Wright,LL; Bose,C
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2012 EN
Relevância na Pesquisa
46.86%
OBJECTIVE: To assess the feasibility of using birth attendants instead of bereaved mothers as perinatal verbal autopsy respondents. METHODS: Verbal autopsy interviews for early neonatal deaths and stillbirths were conducted separately among mothers (reference standard) and birth attendants in 38 communities in four developing countries. Concordance between maternal and attendant responses was calculated for all questions, for categories of questions and for individual questions. The sensitivity and specificity of individual questions with the birth attendant as respondent were assessed. FINDINGS: For early neonatal deaths, concordance across all questions was 94%. Concordance was at least 95% for more than half the questions on maternal medical history, birth attendance and neonate characteristics. Concordance on any given question was never less than 80%. Sensitivity and specificity varied across individual questions, more than 80% of which had a sensitivity of at least 80% and a specificity of at least 90%. For stillbirths, concordance across all questions was 93%. Concordance was 95% or greater more than half the time for questions on birth attendance, site of delivery and stillborn characteristics. Sensitivity and specificity varied across individual questions. Over 60% of the questions had a sensitivity of at least 80% and over 80% of them had a specificity of at least 90%. Overall...