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The global met need for emergency obstetric care: a systematic review
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Titel: |
The global met need for emergency obstetric care: a systematic review |
In: | BJOG: An International Journal of Obstetrics & Gynaecology, 122, 2015, 2, S. 183-189 |
veröffentlicht: |
Wiley
|
Umfang: | 183-189 |
ISSN: |
1470-0328 1471-0528 |
DOI: | 10.1111/1471-0528.13230 |
Zusammenfassung: | <jats:sec><jats:title>Background</jats:title><jats:p>Of the 287 000 maternal deaths every year, 99% happen in low‐ and middle‐income countries. The vast majority could be averted with timely access to appropriate emergency obstetric care (<jats:styled-content style="fixed-case">E</jats:styled-content>m<jats:styled-content style="fixed-case">OC</jats:styled-content>). The proportion of women with complications of pregnancy or childbirth who actually receive treatment is reported as ‘<jats:styled-content style="fixed-case">M</jats:styled-content>et need for <jats:styled-content style="fixed-case">E</jats:styled-content>m<jats:styled-content style="fixed-case">OC</jats:styled-content>’.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To estimate the global met need for <jats:styled-content style="fixed-case">E</jats:styled-content>m<jats:styled-content style="fixed-case">OC</jats:styled-content> and to examine the correlation between met need, maternal mortality ratio and other indicators.</jats:p></jats:sec><jats:sec><jats:title>Search strategy</jats:title><jats:p>A systematic review was performed according to the <jats:styled-content style="fixed-case">PRISMA</jats:styled-content> guidelines. Searches were made in <jats:styled-content style="fixed-case">P</jats:styled-content>ub<jats:styled-content style="fixed-case">M</jats:styled-content>ed, <jats:styled-content style="fixed-case">EMBASE</jats:styled-content> and <jats:styled-content style="fixed-case">G</jats:styled-content>oogle <jats:styled-content style="fixed-case">S</jats:styled-content>cholar.</jats:p></jats:sec><jats:sec><jats:title>Selection criteria</jats:title><jats:p>Studies containing data on met need in <jats:styled-content style="fixed-case">E</jats:styled-content>m<jats:styled-content style="fixed-case">OC</jats:styled-content> were selected.</jats:p></jats:sec><jats:sec><jats:title>Data collection and analysis</jats:title><jats:p>Analysis was performed with data extracted from 62 studies representing 51 countries. <jats:styled-content style="fixed-case">W</jats:styled-content>orld <jats:styled-content style="fixed-case">B</jats:styled-content>ank data were used for univariate and multiple linear regression.</jats:p></jats:sec><jats:sec><jats:title>Main results</jats:title><jats:p>Global met need for <jats:styled-content style="fixed-case">E</jats:styled-content>m<jats:styled-content style="fixed-case">OC</jats:styled-content> was 45% (<jats:styled-content style="fixed-case">IQR</jats:styled-content>: 28–57%), with significant disparity between low‐ (21% [12–31%]), middle‐ (32% [15‐56%]), and high‐income countries (99% [99–99%]), (<jats:italic>P</jats:italic> = 0.041). This corresponds to 11.4 million (8.8–14.8) untreated complications yearly and 951 million (645–1174 million) women without access to Em<jats:styled-content style="fixed-case">OC</jats:styled-content>. We found an inverse correlation between met need and maternal mortality ratio (<jats:italic>r</jats:italic> = −0.42, <jats:italic>P</jats:italic> < 0.001). Met need was significantly correlated with the proportion of births attended by skilled birth attendants (<jats:italic>β </jats:italic>= 0.53 [95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 0.41–0.65], <jats:italic>P</jats:italic> < 0.001).</jats:p></jats:sec><jats:sec><jats:title>Authors’ conclusions</jats:title><jats:p>The results suggest a considerable inadequacy in global met need for Em<jats:styled-content style="fixed-case">OC</jats:styled-content>, with vast disparities between countries of different income levels. Met need is a powerful indicator of the response to maternal mortality and strategies to improve Em<jats:styled-content style="fixed-case">OC</jats:styled-content> act in synergy with the expansion of skilled birth attendance.</jats:p></jats:sec> |
Format: | E-Article |
Quelle: | Wiley (CrossRef) |
Sprache: | Englisch |