scholarly journals Why Are So Many Nepali Women Killing Themselves? A Review Of Key Issues

2015 ◽  
Vol 1 (4) ◽  
pp. 43-49 ◽  
Author(s):  
P Simkhada ◽  
E Van Teijlingen ◽  
R C Winter ◽  
C Fanning ◽  
A Dhungel ◽  
...  

For decades the maternal mortality in Nepal was the lead cause of death among women, with serious improvements in the maternal mortality ratio in the twentieth century the second most common cause has become more prominent. Suicide is now one of the leading causes of death for women of a reproductive age in Nepal. This scoping review brings together the key available literature to identify the causes of suicide among women in Nepal. Published and unpublished studies and the grey literature published on women and suicide related to Nepal between 2000 and 2014 were searched and included in this review. This review suggested a number of explanations for high rate of suicide among women including: partner violence, alcoholism and polygamy, the culture of silence, early age marriage and prolonged child bearing and dependency on men for financial security. This paper highlights some challenges and suggests ways forward in the improvement of mental health in Nepal.DOI: http://dx.doi.org/10.3126/jmmihs.v1i4.12001Journal of Manmohan Memorial Institute of Health Sciences Vol. 1, Issue 4, 2015Page: 43-49

Author(s):  
Janete Vettorazzi ◽  
Edimárlei Gonsales Valério ◽  
Maria Alexandrina Zanatta ◽  
Mariana Hollmann Scheffler ◽  
Sergio Hofmeister de Almeida Martins Costa ◽  
...  

Abstract Objective To determine the profile of maternal deaths occurred in the period between 2000 and 2019 in the Hospital de Clínicas de Porto Alegre (HCPA, in the Portuguese acronym) and to compare it with maternal deaths between 1980 and 1999 in the same institution. Methods Retrospective study that analyzed 2,481 medical records of women between 10 and 49 years old who died between 2000 and 2018. The present study was approved by the Ethics Committee (CAAE 78021417600005327). Results After reviewing 2,481 medical records of women who died in reproductive age, 43 deaths had occurred during pregnancy or in the postpartum period. Of these, 28 were considered maternal deaths. The maternal mortality ratio was 37.6 per 100,000 live births. Regarding causes, 16 deaths (57.1%) were directly associated with pregnancy, 10 (35.1%) were indirectly associated, and 2 (7.1%) were unrelated. The main cause of death was hypertension during pregnancy (31.2%) followed by acute liver steatosis during pregnancy (25%). In the previous study, published in 2003 in the same institution4, the mortality rate was 129 per 100,000 live births, and most deaths were related to direct obstetric causes (62%). The main causes of death in this period were due to hypertensive complications (17.2%), followed by postcesarean infection (16%). Conclusion Compared with data before the decade of 2000, there was an important reduction in maternal deaths due to infectious causes.


2016 ◽  
Vol 4 (2) ◽  
pp. 178-186
Author(s):  
Jose Campbell ◽  
Eliana Duarte Osis

Maternal mortality, as a largely avoidable cause of death and reduction in maternal mortality has been a top priority in Brazil, despite massive program efforts to avert maternal deaths, the maternal mortality ratio (MMR) in Brazil is still high especially in the poor area. Estimates of maternal mortality rates in Brazil are affected by underreporting of deaths, especially in less developed areas of the country where maternal mortality tends to be higher, and the absence of specific information indicating maternal death in reported deaths of women of reproductive age The objective of this study is to identify the true number of maternal deaths. We use data obtained from Ministry of Health information systems from the 2000 and 2012 Brazil Maternal Mortality Surveys to measure change in the maternal mortality ratio (MMR) and to measure changes in factors potentially related to such change. We estimate the changes in risk of maternal death between the two surveys using Poisson regression.


2013 ◽  
Vol 6 (2) ◽  
pp. 64-69 ◽  
Author(s):  
Sonia Shirin ◽  
Shamsun Nahar

Maternal mortality is an important indicator which reflects the health status of a community. It can be calculated by maternal mortality ratio (MMR), maternal mortality rate (MMRate), and adult life time risk of maternal death. MMR estimates are based on varieties of methods that include household surveys, sisterhood methods, reproductive-age mortality studies (RAMOS), verbal autopsies and censuses. Main causes of maternal mortality are hemorrhage, infection, unsafe abortion, hypertensive disorder of pregnancy and obstructed labour. Factors of maternal mortality have been conceptualized by three delays model. Estimates of maternal mortality ratio (MMR) trend between 1990 and 2010 (over 20 years period) suggest a global reduction (47%), with a greater reduction in developing countries (47%) including Bangladesh than in developed countries (39%). However, to meet the challenge of Fifth Millennium Development Goal (MDG5 i.e. to ensure 75% reduction of MMR by the year 2015), the annual rate of MMR decline and increase of skilled attendant at birth need to be still faster. DOI: http://dx.doi.org/10.3329/imcj.v6i2.14735 Ibrahim Med. Coll. J. 2012; 6(2): 64-69


2020 ◽  
Author(s):  
Kyrah K Brown ◽  
Godfred O Boateng ◽  
Peace Ossom-Williamson ◽  
Laura Haygood

Abstract Background Despite the global decline in maternal mortality ratio, the burden of this global health problem differs considerably by a country’s economic development status and geographic region. Research suggests that ensuring high-quality maternal care services is crucial for significantly reducing the global maternal mortality ratio. Health practitioners and researchers must be able to measure and assess maternal care quality in facilities; yet, there are many challenges such as lack of consensus on definitions and measures that may not be practical in facility settings. Whereas previous work has focused on clinical indicators used to measure maternal care quality in developing countries, this scoping review will be the first to address the ways in which patient-reported maternal care quality is defined, conceptualized, and measured across low-, middle-, and high-income countries; and to identify, evaluate, and summarize existing patient-reported measures of maternal care quality. Methods For this scoping review, we will conduct searches for peer-reviewed studies from Ovid MEDLINE, Embase, Amed, WHO Global Index Medicus, and grey literature sources. Published studies in English until August 31, 2020 focused on the measurement of maternal care quality will be included. Screening and data extraction will be completed independently by two members of the review team. We will analyze the evidence using a critical appraisal tool and best practice guideline for developing and validating scales. Discussion The review will provide researchers and practitioners with a summary of existing definitions, frameworks, and measures for assessing maternal care quality along with associated psychometric evidence. The review will also lay the groundwork for developing a comprehensive patient-reported maternal care quality measure.


2020 ◽  
Vol 13 (2) ◽  
pp. 197-216
Author(s):  
Romeo Konnon ◽  
Said Semyatov ◽  
Muhammednazar Soyunov ◽  
Zalina Sokhova ◽  
Tatevik Zulumyan

The maternal mortality ratio in the Republic of Benin in 2015 was still high – 405 per 100,000 live births. The delay in consultation and timely treatment, unavailability of medical facilities and lack of skilled care are the principal factors contributing to maternal deaths in Benin. Consequently, the rate of such preventable causes of maternal deaths like obstetric haemorrhage (38.40 percent and pre-eclampsia/eclampsia (14.30 percent) remains high in the country, and even HIV continued being one of the indirect causes of maternal deaths in 2017 – one percent. High rate of complications associated with pregnancy and birth in adolescent girls is another cause of maternal deaths in the Republic of Benin. Despite the efforts of the Government aimed at improving health care, it is unlikely that we will achieve the United Nations Sustainable Development Goals 3.1. – the reduction of maternal mortality ratio to less than 70 per 100,000 live births by 2030.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nina Mendez-Dominguez ◽  
Karen Santos-Zaldívar ◽  
Salvador Gomez-Carro ◽  
Sudip Datta-Banik ◽  
Genny Carrillo

Abstract Background In Mexico, the COVID-19 pandemic led to preventative measures such as confinement and social interaction limitations that paradoxically may have aggravated healthcare access disparities for pregnant women and accentuated health system weaknesses addressing high-risk patients’ pregnancies. Our objective is to estimate the maternal mortality ratio in 1 year and analyze the clinical course of pregnant women hospitalized due to acute respiratory distress syndrome and COVID-19. Methods A retrospective surveillance study of the national maternal mortality was performed from February 2020–February 2021 in Mexico related to COVID-19 cases in pregnant women, including their outcomes. Comparisons were made between patients who died and those who survived to identify prognostic factors and underlying health conditions distribution. Results Maternal Mortality Ratio increased by 56.8% in the studied period, confirmed COVID-19 was the cause of 22.93% of cases. Additionally, unconfirmed cases represented 4.5% of all maternal deaths. Among hospitalized pregnant women with Acute Respiratory Distress Syndrome consistent with COVID-19, smoking and cardiovascular diseases were more common among patients who faced a fatal outcome. They were also more common in the age group of < 19 or > 38. In addition, pneumonia was associated with asthma and immune impairment, while diabetes and increased BMI increased the odds for death (Odds Ratio 2.30 and 1.70, respectively). Conclusions Maternal Mortality Ratio in Mexico increased over 60% in 1 year during the pandemic; COVID-19 was linked to 25.4% of maternal deaths in the studied period. Lethality among pregnant women with a diagnosis of COVID-19 was 2.8%, and while asthma and immune impairment increased propensity for developing pneumonia, obesity and diabetes increased the odds for in-hospital death. Measures are needed to improve access to coordinated well-organized healthcare to reduce maternal deaths related to COVID-19 and pandemic collateral effects.


Author(s):  
Darshna M. Patel ◽  
Mahesh M. Patel ◽  
Vandita K. Salat

Background: According to the WHO, 80 of maternal deaths in developing countries are due to direct maternal causes such as haemorrhage, hypertensive disorders and sepsis. These deaths are largely preventable. Maternal mortality ratio (MMR) in India is 167/100,000 live births.Methods: This retrospective observational study was conducted at GMERS, Valsad. Data regarding maternal deaths from January 2016 to December 2017 were collected and analyzed with respect to epidemiological parameters. The number of live births in the same period was obtained from the labour ward ragister. Maternal mortality rate and Mean maternal mortality ratio for the study period was calculated.Results: The mean Maternal mortality rate in the study period was 413.3/100,000 births. The maternal mortality ratio (MMR) in India is 167/100,000 live births. More than half of maternal deaths were reported in multiparous patients. More maternal deaths were observed in women from rural areas (67.3%), unbooked patients (73.3%) and illiterate women (65.3%). Thirty six (69.3%) maternal death occurred during postpartum period. Most common delay was first delay (60.0%) followed by second delay (40.0%). Postpartum haemorrhage (28.8%), preeclampsia (17.3%), sepsis (13.46%) were the major direct causes of maternal deaths. Indirect causes accounted for one third of maternal deaths in our study. Anemia, hepatitis and heart disease were responsible for 13.4%, 5.7%, and 1.9% of maternal deaths, respectively.Conclusions: Majority of maternal deaths are observed in patients from rural areas, unbooked, and illiterate patients. Hemorrhage, eclampsia and sepsis are leading causes of maternal deaths. Most of these maternal deaths are preventable if patients are given appropriate treatment at periphery and timely referred to higher centers.


2011 ◽  
Vol 31 (4) ◽  
pp. 315-319 ◽  
Author(s):  
B. A. Oye-Adeniran ◽  
K. A. Odeyemi ◽  
A. Gbadegesin ◽  
E. E. Ekanem ◽  
O. K. Osilaja ◽  
...  

2014 ◽  
Vol 48 (4) ◽  
pp. 662-670 ◽  
Author(s):  
Ioná Carreno ◽  
Ana Lúcia de Lourenzi Bonilha ◽  
Juvenal Soares Dias da Costa

OBJECTIVE To analyze the temporal evolution of maternal mortality and its spatial distribution.METHODS Ecological study with a sample made up of 845 maternal deaths in women between 10 and 49 years, registered from 1999 to 2008 in the state of Rio Grande do Sul, Southern Brazil. Data were obtained from Information System on Mortality of Ministry of Health. The maternal mortality ratio and the specific maternal mortality ratio were calculated from records, and analyzed by the Poisson regression model. In the spatial distribution, three maps of the state were built with the rates in the geographical macro-regions, in 1999, 2003, and 2008.RESULTS There was an increase of 2.0% in the period of ten years (95%CI 1.00;1.04; p = 0.01), with no significant change in the magnitude of the maternal mortality ratio. The Serra macro-region presented the highest maternal mortality ratio (1.15, 95%CI 1.08;1.21; p < 0.001). Most deaths in Rio Grande do Sul were of white women over 40 years, with a lower level of education. The time of delivery/abortion and postpartum are times of increased maternal risk, with a greater negative impact of direct causes such as hypertension and bleeding.CONCLUSIONS The lack of improvement in maternal mortality ratio indicates that public policies had no impact on women’s reproductive and maternal health. It is needed to qualify the attention to women’s health, especially in the prenatal period, seeking to identify and prevent risk factors, as a strategy of reducing maternal death.


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