Barriers to obstetric care among maternal near-misses

dc.contributor.authorSoma-Pillay, Priya
dc.contributor.authorPattinson, Robert Clive
dc.contributor.emailpriya.somapillay@up.ac.zaen_ZA
dc.date.accessioned2016-12-21T07:41:57Z
dc.date.available2016-12-21T07:41:57Z
dc.date.issued2016-11
dc.description.abstractBACKGROUND. There are several factors in the healthcare system that may influence a woman’s ability to access appropriate obstetric care. OBJECTIVE. To determine the delays/barriers in providing obstetric care to women who classified as a maternal near-miss. METHODS. This was a descriptive observational study at Steve Biko Academic Hospital, a tertiary referral hospital in Pretoria, South Africa. One hundred maternal near-misses were prospectively identified using the World Health Organization criteria. The ‘three-delays model’ was used to identify the phases of delay in the health system and recorded by the doctor caring for the patient. RESULTS. One or more factors causing a delay in accessing care were identified in 83% of near-miss cases. Phase I and III delays were the most important causes of barriers. Lack of knowledge of the problem (40%) and inadequate antenatal care (37%) were important first-phase delays. Delay in patient admission, referral and treatment (37%) and substandard care (36%) were problems encountered within the health system. The above causes were also the most important factors causing delays for the leading causes of maternal near-misses – obstetric haemorrhage, hypertension/pre-eclampsia, and medical and surgical conditions. CONCLUSIONS. Maternal morbidity and mortality rates may be reduced by educating the community about symptoms and complications related to pregnancy. Training healthcare workers to identify and manage obstetric emergencies is also important. The frequency of antenatal visits should be revised, with additional visits in the third trimester allowing more opportunities for blood pressure to be checked and for identifying hypertension.en_ZA
dc.description.departmentObstetrics and Gynaecologyen_ZA
dc.description.librarianam2016en_ZA
dc.description.urihttp://www.samj.org.zaen_ZA
dc.identifier.citationSoma-Pillay, P & Pattinson, RC 2016, 'Barriers to obstetric care among maternal near-misses', South African Medical Journal, vol. 106, no. 11, pp. 1110-1113.en_ZA
dc.identifier.issn0256-9574 (print)
dc.identifier.issn2078-5135 (online)
dc.identifier.other10.7196/SAMJ.2016.v106i11.10726
dc.identifier.urihttp://hdl.handle.net/2263/58435
dc.language.isoenen_ZA
dc.publisherHealth and Medical Publishing Groupen_ZA
dc.rights© 2016 Health & Medical Publishing Group. This work is licensed under a Creative Commons Attribution-NonCommercial Works License (CC BY-NC 3.0).en_ZA
dc.subjectHealthcare systemen_ZA
dc.subjectObstetric careen_ZA
dc.subjectDoctoren_ZA
dc.subjectWomenen_ZA
dc.subjectMaternal near-missen_ZA
dc.titleBarriers to obstetric care among maternal near-missesen_ZA
dc.typeArticleen_ZA

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