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Reducing maternal morbidity and mortality in the developing world: a simple, cost-effective example

Authors Browning A, Menber B

Received 29 September 2014

Accepted for publication 30 October 2014

Published 4 February 2015 Volume 2015:7 Pages 155—159

DOI https://dx.doi.org/10.2147/IJWH.S75097

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Elie Al-Chaer

Andrew Browning,1,2 Birhanu Menber2

1Maternity Africa, Arusha, Tanzania; 2Vision Maternity Care, Barhirdar, Ethiopia


Objectives: To determine the impact of volunteer obstetricians and midwife teams on obstetric services in a rural hospital in Ethiopia.
Methods: The intervention was undertaken in Mota district hospital, a rural hospital in the Amhara region of Ethiopia, which is the only hospital for 1.2 million people. Before the placement of volunteer teams it had a rudimentary basic obstetric service, no blood transfusion service, and no operative delivery. The study prospectively analyzed delivery data before, during, and after the placement of volunteer obstetrician and midwife teams. The volunteers established emergency obstetric care, and trained and supervised local staff over a 3-year period. Measurable outcomes consisted of the number of women delivering, the number of referrals of pregnant women, the number of maternal deaths, and the number of referrals of obstetric fistula patients.
Results: With the establishment of the service the number of women attending hospital for delivery increased by 40%. In the hospital maternal mortality decreased from 7.1% to <0.5%, and morbidity, as measured by number of obstetric fistulae, decreased from 1.5% deliveries to 0.5% over the 3-year intervention period. The improvements were sustained after handing the project back to the government.
Conclusion: The placement of volunteer teams was an effective method of decreasing maternal mortality and morbidity.

Keywords: emergency obstetric care, volunteers, obstetric fistula, emergency obstetric care

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