MyMedR

Maternal health: a missed opportunity for development

Grépin KA, Klugman J

Lancet, 2013 May 18;381(9879):1691-3.

PMID: 23683617 DOI: 10.1016/S0140-6736(13)60981-2

Matched MeSH terms: Maternal Welfare*

JICWELS' MCH training program in the Aiiku Institute: Asian MCH workshop

Hirayama M, Oyama O, Asano M

Acta Paediatr Jpn, 1993 Dec;35(6):579-82.

PMID: 8109245

Taking a form of Official Development Aid (ODA), the Japan International Cooperation of Welfare Services (JICWELS) and Imperial Gift Foundation, Boshi-Aiiku-Kai (Aiiku Association for Maternal and Child Health and Welfare) have extended a study program on maternal and child health (MCH) since 1989 on the commission of the Ministry of Health and Welfare. 'Community participation' is the key to the first international study program focused solely on MCH. The purpose of the program is to help to improve the planning and administration in the field of MCH. Through this, the information and experience attained in Japanese MCH activities are introduced especially by participation in community-level activities of 'Aiiku-Han' in which local citizens play a major role. The operation system of the Asian MCH Workshop, contents of the workshop, evaluation and future prospects are discussed.

Matched MeSH terms: Maternal Welfare*

Malaysia: changes in abortion law

Lancet, 1990 May 19;335(8699):1209.

PMID: 11642854

Matched MeSH terms: Maternal Welfare

Fulltext Maternal, neonatal, and child health in southeast Asia: towards greater regional collaboration

Acuin CS, Khor GL, Liabsuetrakul T, Achadi EL, Htay TT, Firestone R, et al.

Lancet, 2011 Feb 05;377(9764):516-25.

PMID: 21269675 DOI: 10.1016/S0140-6736(10)62049-1

Although maternal and child mortality are on the decline in southeast Asia, there are still major disparities, and greater equity is key to achieve the Millennium Development Goals. We used comparable cross-national data sources to document mortality trends from 1990 to 2008 and to assess major causes of maternal and child deaths. We present inequalities in intervention coverage by two common measures of wealth quintiles and rural or urban status. Case studies of reduction in mortality in Thailand and Indonesia indicate the varying extents of success and point to some factors that accelerate progress. We developed a Lives Saved Tool analysis for the region and for country subgroups to estimate deaths averted by cause and intervention. We identified three major patterns of maternal and child mortality reduction: early, rapid downward trends (Brunei, Singapore, Malaysia, and Thailand); initially high declines (sustained by Vietnam but faltering in the Philippines and Indonesia); and high initial rates with a downward trend (Laos, Cambodia, and Myanmar). Economic development seems to provide an important context that should be coupled with broader health-system interventions. Increasing coverage and consideration of the health-system context is needed, and regional support from the Association of Southeast Asian Nations can provide increased policy support to achieve maternal, neonatal, and child health goals.

Matched MeSH terms: Maternal Welfare*

Maternal influences on low birth weight

Tin TT, Thida M, Maung MM, Wai KT

Malays J Reprod Health, 1994 Jun;12(1):32-7.

PMID: 12320337

PIP: To identify the maternal risk factors associated with low birth weight in Malaysia, the records of the 2613 infants delivered at North Okkalapa General Hospital from January to September 1990 were reviewed. The incidence of low birth weight during the 9-month study period was 21.1%; 18.1% of these cases were attributable to intrauterine growth retardation and 3% were associated with preterm births. Univariate analysis identified the following risk factors as significant: age under 20 years (.001), parity 1 (.001), maternal height of 145 cm or under (.01), maternal cigarette smoking (.01), maternal education of 8 years or less (.001), parity 5 or above (.05), and maternal age of 35 years and above (.05). A last birth interval of 1 year or less and more than 3 years was associated with an odds ratio exceeding 1, but the correlation with low birth weight was not significant. These risk factors should be used to design maternal health programs aimed at reducing the incidence of low birth weight.

Matched MeSH terms: Maternal Welfare*

Fulltext Impact of increasing capacity for generating and using research on maternal and perinatal health practices in South East Asia (SEA-ORCHID Project)

SEA-ORCHID Study Group, Lumbiganon P, McDonald SJ, Laopaiboon M, Turner T, Green S, et al.

PLoS One, 2011;6(9):e23994.

PMID: 21915274 DOI: 10.1371/journal.pone.0023994

BACKGROUND: Maternal and neonatal mortality and morbidity remain unacceptably high in many low and middle income countries. SEA-ORCHID was a five year international collaborative project in South East Asia which aimed to determine whether health care and health outcomes for mothers and babies could be improved by developing capacity for research generation, synthesis and use.

METHODS: Nine hospitals in Indonesia, Malaysia, the Philippines and Thailand participated in SEA-ORCHID. These hospitals were supported by researchers from three Australian centres. Health care practices and outcomes were assessed for 1000 women at each hospital both before and after the intervention. The capacity development intervention was tailored to the needs and context of each hospital and delivered over an 18 month period. Main outcomes included adherence to forms of care likely to be beneficial and avoidance of forms of care likely to be ineffective or harmful.

RESULTS: We observed substantial variation in clinical practice change between sites. The capacity development intervention had a positive impact on some care practices across all countries, including increased family support during labour and decreased perineal shaving before birth, but in some areas there was no significant change in practice and a few beneficial practices were followed less often.

CONCLUSION: The results of SEA-ORCHID demonstrate that investing in developing capacity for research use, synthesis and generation can lead to improvements in maternal and neonatal health practice and highlight the difficulty of implementing evidence-based practice change.

Matched MeSH terms: Maternal Welfare/statistics & numerical data*

Hospital discharge on the first compared with the second day after a planned cesarean delivery: a randomized controlled trial

Tan PC, Norazilah MJ, Omar SZ

Obstet Gynecol, 2012 Dec;120(6):1273-82.

PMID: 23168750 DOI: http://10.1097/AOG.0b013e3182723a95

To compare patient satisfaction and exclusive breastfeeding rates for patients discharged from the hospital on postcesarean day 1 (next day) or day 2.

Matched MeSH terms: Maternal Welfare/psychology

Study of perinatal mortality 1970, Maternity Hospital. Kuala Lumpur

Ariffin Bin Marzuki, Thambu JA

Med J Malaysia, 1973 Mar;27(3):198-202.

PMID: 4268924

Matched MeSH terms: Maternal Welfare

When Pregnancy Goes SOUTH: Keeping Birth Gentle

Lim R

Midwifery Today Int Midwife, 2015.

PMID: 26309925

Matched MeSH terms: Maternal Welfare/statistics & numerical data*

Maternal and child health in urban Sabah, Malaysia: a comparison of citizens and migrants

Zulkifli SN, U KM, Yusof K, Lin WY

Asia Pac J Public Health, 1994;7(3):151-8.

PMID: 7794653 DOI: 10.1177/101053959400700302

This paper describes selected maternal and child health indicators based on a cross-sectional study of citizens and migrants in Sabah, Malaysia. A total of 1,515 women were interviewed from a multi-stage random sample of households in eight urban centers. Among the 1,411 women in the sample who had experienced a pregnancy before, 76% were local citizens and 24% were migrants. There were statistically significant differences between citizens and migrants in ethnicity, religion, education, household income, and access to treated water supply and sanitary toilet facilities. Significantly fewer migrants practiced any form of contraception and obtained any antenatal care during any pregnancy. Furthermore, citizens tended to initiate care as early as three months but migrants as late as seven months. Despite these differences, only the infant mortality rate, and not pregnancy wastage, was statistically significantly higher among migrants. Pregnancy interval was also similar between the two groups. The influence of several socioeconomic factors on pregnancy wastage and infant mortality was explored.

Matched MeSH terms: Maternal Welfare*

Fulltext Ethnicity and infant mortality in Malaysia

Dixon G

Asia Pac Popul J, 1993 Jun;8(2):23-54.

PMID: 12287522

PIP: Malaysian infant mortality differentials are a worthwhile subject for study, because socioeconomic development has very clearly had a differential impact by ethnic group. The Chinese rates of infant mortality are significantly lower than the Malay or Indian rates. Instead of examining the obvious access to care issues, this study considered factors related to the culture of infant care. Practices include the Chinese confinement of the mother in the first month after childbirth ("pe'i yue") and Pillsbury's 12 normative rules for Malaysian Chinese care. Malay practices vary widely by region and history. Indian mothers are restricted by diet. Data-recording flaws do not permit analysis of Sarawak or Sabah. The general assumption that Western medicine favors better health for mothers and infants is substantiated among peninsular communities, however, there are also negative impacts which affect infant mortality. The complex interaction of factors impacting on infant mortality reported in seven previous studies is discussed. A review of these studies reveals that immediate causes are infections, injuries, and dehydration. Indirect causes are birth weight or social and behavioral factors such as household income or maternal education. Indirect factors, which are amenable to planned change and influence the biological proximate determinants of infant mortality, are identified as birth weight, maternal age at birth, short pregnancy intervals or prior reproductive loss, sex of the child, birth order, duration of breast feeding and conditions of supplementation, types of household water and sanitation, year of child's birth, maternal education, household income and composition, institution of birth, ethnicity, and rural residence. Nine factors are identified empirically as not significant: maternal hours of work in the child's first year, maternal occupation, distance from home to workplace, presence of other children or servants, incidence of epidemics in the child's first year of life, community types of sanitation, prices and availability of infant foods, and access to various types of medical care. Future empirical study should consider factors such as class differences, place of residence, or extent of illiteracy as underlying or related to ethnicity. Policy-makers should be aware that future decline in infant mortality rates may depend on the blending of traditional with modern practices.

Matched MeSH terms: Maternal Welfare*

MATERNITY SERVICES IN FEDERATION OF MALAYA

LOURDENADIN S

Med J Malaysia, 1963 Jun;17:269-73.

PMID: 14060503

Matched MeSH terms: Maternal Welfare*

The influence of maternal ethnic group and diet on breast milk fatty acid composition

Su LL, S K TC, Lim SL, Chen Y, Tan EA, Pai NN, et al.

Ann Acad Med Singap, 2010 Sep;39(9):675-5.

PMID: 20957301

INTRODUCTION: Breast milk fatty acids play a major role in infant development. However, no data have compared the breast milk composition of different ethnic groups living in the same environment. We aimed to (i) investigate breast milk fatty acid composition of three ethnic groups in Singapore and (ii) determine dietary fatty acid patterns in these groups and any association with breast milk fatty acid composition.

MATERIALS AND METHODS: This was a prospective study conducted at a tertiary hospital in Singapore. Healthy pregnant women with the intention to breastfeed were recruited. Diet profile was studied using a standard validated 3-day food diary. Breast milk was collected from mothers at 1 to 2 weeks and 6 to 8 weeks postnatally. Agilent gas chromatograph (6870N) equipped with a mass spectrometer (5975) and an automatic liquid sampler (ALS) system with a split mode was used for analysis.

RESULTS: Seventy-two breast milk samples were obtained from 52 subjects. Analysis showed that breast milk ETA (Eicosatetraenoic acid) and ETA:EA (Eicosatrienoic acid) ratio were significantly different among the races (P = 0.031 and P = 0.020), with ETA being the highest among Indians and the lowest among Malays. Docosahexaenoic acid was significantly higher among Chinese compared to Indians and Malays. No difference was demonstrated in n3 and n6 levels in the food diet analysis among the 3 ethnic groups.

CONCLUSIONS: Differences exist in breast milk fatty acid composition in different ethnic groups in the same region, although no difference was demonstrated in the diet analysis. Factors other than maternal diet may play a role in breast milk fatty acid composition.

Matched MeSH terms: Maternal Welfare*

Fulltext Maternal melanoma with placental metastasis

Shuhaila A, Rohaizak M, Phang KS, Mahdy ZA

Singapore Med J, 2008 Mar;49(3):e71-2.

PMID: 18362990

A 40-year-old woman, a grand multipara with uncertain gestation, presented with severe, prolonged diarrhoea. She was previously diagnosed to have melanoma. Examination revealed gross ascites with hepatosplenomegaly and uterus corresponding to 29 weeks gestation. An emergency caesarean section confirmed widespread metastases to the ovaries, mesentery and placenta. A viable male foetus was delivered with features of intrauterine growth restriction. The baby survived, but the mother died a week later. This case highlights the importance of thoroughly assessing placentas and babies of patients with melanoma for metastases.

Matched MeSH terms: Maternal Welfare

Fulltext Building capacity for evidence generation, synthesis and implementation to improve the care of mothers and babies in South East Asia: methods and design of the SEA-ORCHID Project using a logical framework approach

McDonald S, Turner T, Chamberlain C, Lumbiganon P, Thinkhamrop J, Festin MR, et al.

BMC Med Res Methodol, 2010;10:61.

PMID: 20594325 DOI: 10.1186/1471-2288-10-61

Rates of maternal and perinatal mortality remain high in developing countries despite the existence of effective interventions. Efforts to strengthen evidence-based approaches to improve health in these settings are partly hindered by restricted access to the best available evidence, limited training in evidence-based practice and concerns about the relevance of existing evidence. South East Asia--Optimising Reproductive and Child Health in Developing Countries (SEA-ORCHID) was a five-year project that aimed to determine whether a multifaceted intervention designed to strengthen the capacity for research synthesis, evidence-based care and knowledge implementation improved clinical practice and led to better health outcomes for mothers and babies. This paper describes the development and design of the SEA-ORCHID intervention plan using a logical framework approach.

Matched MeSH terms: Maternal Welfare

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