A comprehensive assessment of maternal deaths in Argentina: translating multicentre collaborative research into action

被引:32
作者
Ramos, Silvina
Karolinski, Ariel
Romero, Mariana
Mercer, Raul
机构
[1] Hlth Res Council, Minist Hlth, AMBA, Buenos Aires, DF, Argentina
[2] Ctr Study State & Soc, CEDES, Buenos Aires, DF, Argentina
[3] Natl Council Sci & Technol Res, CONICET, Buenos Aires, DF, Argentina
[4] CEDES, Buenos Aires, DF, Argentina
[5] AMBA Perinatal Network, Buenos Aires, DF, Argentina
关键词
D O I
10.2471/BLT.06.032334
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objective To perform a comprehensive assessment of maternal mortality in Argentina, the ultimate purpose being to strengthen the surveillance system and reorient reproductive health policies to prevent maternal deaths. Methods Our multicentre population-based study combining qualitative and quantitative methodologies included a descriptive analysis of under-registration and distribution of causes of death, a case-control study to identify risk factors in health-care delivery and verbal autopsies to analyse social determinants associated with maternal deaths. Findings A total of 121 maternal deaths occurred during 2002. The most common causes were abortion complications (27.4%), haemorrhage (22.1%), infection/sepsis (9.5%), hypertensive disorders (8.4%) and other causes (32.6%). Under-registration was 9.5% for maternal deaths (n = 95) and 15.4% for late maternal deaths (n = 26). The probability of dying was 10 times greater in the absence of essential obstetric care, active emergency care and qualified staff, and doubled with every 10-year increase in age. Other contributing factors included delays in recognizing "alarm signals"; reluctance in seeking care owing to desire to hide an induced abortion; delays in receiving timely treatment due to misdiagnosis or lack of supplies; and delays in referral/transportation in rural areas. Conclusion A combination of methodologies is required to improve research on and understanding of maternal mortality via the systematic collection of health surveillance data. There is an urgent need for a comprehensive intervention to address public health and human rights issues in maternal mortality, and our results contribute to the consensus-building necessary to improve the existing surveillance system and prevention strategies.
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页码:615 / 622
页数:8
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