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3. Covid-19

Author

Jayaratne, Kapila, primary, Dissanayake, Vajira, additional, and Karunapema, Palitha, additional

Published
2022
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4. International virtual confidential reviews of infection-related maternal deaths and near-miss in 11 low- and middle-income countries – case report series and suggested actions

Author

Okafor, Obiageli, Roos, Nathalie, Abdosh, Abdulfetah Abdulkadir, Adesina, Olubukola, Alaoui, Zaynab, Romero, William Arriaga, Assarag, Bouchra, Aworinde, Olufemi, de Bernis, Luc, Castro, Rigoberto, Chrifi, Hassan, Day, Louise Tina, Demissew, Rahel, Aceituno, María Guadalupe Flores, Gadama, Luis, Gashawbeza, Biruck, Keke, Sourou Goufodji, Govule, Philip, Gwako, George, Jayaratne, Kapila, Komboigo, Evelyne Béwendin, Lara, Bredy, Madziyire, Mugove Gerald, Mathai, Matthews, Moulki, Rachid, Moutaouadia, Iatimad, Munjanja, Stephen, Fletes, Carlos Alberto Ochoa, Ortiz, Edgar Ivan, Ouedraogo, Henri Gautier, Qureshi, Zahida, Recidoro, Zenaida Dy, Senanayake, Hemantha, Soma-Pillay, Priya, Tin, Khaing Nwe, Sedami, Pascal, Worku, Dawit, and Bonet, Mercedes

Published
2022
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5. Availability of facility resources and services and infection-related maternal outcomes in the WHO Global Maternal Sepsis Study: a cross-sectional study

Author

Brizuela, Vanessa, Cuesta, Cristina, Bartolelli, Gino, Abdosh, Abdulfetah Abdulkadir, Abou Malham, Sabina, Assarag, Bouchra, Castro, Rigoberto, Díaz, Virginia, El Kak, Faysal, Elsheikh, Mohamed, Pérez, Aquilino M., Souza, João Paulo, Bonet, Mercedes, Abalos, Edgardo, Aman, Mohammad Iqbal, Noormal, Bashir, Espinoza, Marisa, Pasquale, Julia, Leroy, Charlotte, Roelens, Kristien, Vandenberghe, Griet, Agossou, M. Christian Urlyss, Goufodji Keke, Sourou, Tshabu Aguemon, Christiane, Apaza Peralta, Patricia Soledad, Conde Altamirano, Víctor, Hernández Muñoz, Rosalinda, Cecatti, José Guilherme, Ribeiro do Valle, Carolina, Batiene, Vincent, Cisse, Kadari, Ouedraogo, Henri Gautier, Cheang, Kannitha, Lam, Phirun, Rathavy, Tung, Simo, Elie, Tebeu, Pierre-Marie, Yakana, Emah Irene, Carvajal, Javier, Escobar, María Fernanda, Fernández, Paula, Colmorn, Lotte Berdiin, Langhoff-Roos, Jens, Mereci, Wilson, Vélez, Paola, Salah Eldin, Yasser, Sultan, Alaa, Teklu, Alula M., Worku, Dawit, Adanu, Richard, Govule, Philip, Noora Lwanga, Charles, Arriaga Romero, William Enrique, Flores Aceituno, María Guadalupe, Bustillo, Carolina, Lara, Bredy, Kumar, Vijay, Suri, Vanita, Trikha, Sonia, Cetin, Irene, Donati, Serena, Personeni, Carlo, Baimussanova, Guldana, Kabylova, Saule, Sagyndykova, Balgyn, Gwako, George, Osoti, Alfred, Qureshi, Zahida, Asylbasheva, Raisa, Boobekova, Aigul, Seksenbaeva, Damira, Itani, Saad Eddine, Minkauskienė, Meilė, Ramašauskaitė, Diana, Chikhwaza, Owen, Gadama, Luis, Malunga, Eddie, Dembele, Haoua, Sangho, Hamadoun, Zerbo, Fanta Eliane, Dávila Serapio, Filiberto, Herrera Maldonado, Nazarea, Islas Castañeda, Juan I., Cauaus, Tatiana, Curteanu, Ala, Petrov, Victor, Buyanjargal, Yadamsuren, Khishgee, Seded, Lkhagvasuren, Bat-Erdene, Essolbi, Amina, Moulki, Rachid, Jaze, Zara, Mariano, Arlete, Bique Osman, Nafissa, Einda, Hla Mya Thway, Maung, Thae Maung, Tin, Khaing Nwe, Gurung, Tara, Shrestha, Amir Babu, Shrestha, Sangeeta, Bloemenkamp, Kitty, Rijken, Marcus J., Van Den Akker, Thomas, Estrada, María Esther, Pavón Gómez, Néstor J., Adesina, Olubukola, Aimakhu, Chris, Fawole, Bukola, Chaudhri, Rizwana, Hamid, Saima, Khan, M. Adnan, Huatuco Hernández, María del Pilar, Zavaleta Pimentel, Nelly M., Andal, Maria Lu, Recidoro, Zenaida Dy, Martin, Carolina Paula, Budianu, Mihaela, Puşcaşiu, Lucian, Diouf, Léopold, Guirassy, Dembo, Moreira, Philippe Marc, Borovsky, Miroslav, Kovac, Ladislav, Kristufkova, Alexandra, Cebekhulu, Sylvia, Cornelissen, Laura, Soma-Pillay, Priya, Cararach, Vicenç, López, Marta, Vidal Benedé, María José, Jayakody, Hemali, Jayaratne, Kapila, Rowel, Dhammica, Nabag, Wisal, Omer, Sara, Tsoy, Victoria, Uzakova, Urunbish, Yunusova, Dilrabo, Siriwachirachai, Thitiporn, Tangsiriwatthana, Thumwadee, Dunlop, Catherine, Knight, Marian, Lissauer, David, Roman, Jhon, Vitureira, Gerardo, Tuan, Dinh Anh, Truong, Luong Ngoc, Hanh, Nghiem Thi Xuan, Madziyire, Mugove, Magwali, Thulani, Munjanja, Stephen, Baguiya, Adama, Chamillard, Mónica, Kouanda, Seni, Lumbiganon, Pisake, Nabhan, Ashraf, Nadisauskiene, Ruta, Bartlett, Linda, Bellissimo-Rodrigues, Fernando, Jacob, Shevin T., Shakoor, Sadia, Yunis, Khalid, Campodónico, Liana, Gamerro, Hugo, Giordano, Daniel, Althabe, Fernando, Gülmezoglu, A. Metin, Castro Banegas, Rigoberto, El-Kak, Faysal, El Sheikh, Mohamed, and Pérez, Aquilino M

Published
2021
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6. Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study

Author

Bonet, Mercedes, Brizuela, Vanessa, Abalos, Edgardo, Cuesta, Cristina, Baguiya, Adama, Chamillard, Mónica, Fawole, Bukola, Knight, Marian, Kouanda, Seni, Lumbiganon, Pisake, Nabhan, Ashraf, Nadisauskiene, Ruta J, Abdulkadir, Abdulfetah, Adanu, Richard MK, Aman, Mohammad Iqbal, Arriaga Romero, William E., Assarag, Bouchra, Bloemenkamp, Kitty W.M., Boobekova, Aigul, Budianu, Mihaela A., Cararach, Vicenç, Castro, Rigoberto, Cebekhulu, Sylvia, Cecatti, José Guilherme, Colmorn, Lotte Berdiin, Curteanu, Ala, Donati, Serena, Einda, Hla Mya Thway, El Deen, Yasser Salah, El Kak, Faysal, Elsheikh, Mohamed, Escobar-Vidarte, Maria F, Espinoza, Marisa Mabel, Estrada, María Ester, Gadama, Luis Aaron, Goufodji, Sourou B, Hamid, Saima, Hernandez Munoz, Rosalinda, Herrera Maldonado, Nazarea, Jayaratne, Kapila, Kabylova, Saule, Kristufkova, Alexandra, Kumar, Vijay, Lissauer, David, Mereci, Wilson, Minkauskiene, Meile, Moreira, Philippe, Munjanja, Stephen, B. Osman, Nafissa, Ouedraogo, Henri Gautier, Perez, Aquilino M., Pasquale, Julia, Puscasiu, Lucian, Qureshi, Zahida, Recidoro, Zenaida, C. Ribeiro-do-Valle, Carolina, Rowel, Dhammica, Sangho, Hamadoun, Shrestha, Amir Babu, Siriwachirachai, Thitiporn, Tebeu, Pierre Marie, Tin, Khaing Nwe, Tuan, Dinh Anh, Tung, Rathavy, Vandenberghe, Griet, Yadamsuren, Buyanjargal, Yunusova, Dilrabo, Zavaleta Pimentel, Nelly, Noormal, Bashir, Díaz, Virginia, Leroy, Charlotte, Roelens, Kristien, Agossou, M. Christian Urlyss, Tshabu Aguemon, Christiane, Apaza Peralta, Patricia Soledad, Conde Altamirano, Víctor, Batiene, Vincent, Cisse, Kadari, Cheang, Kannitha, Lam, Phirun, Simo, Elie, Yakana, Emah Irene, Carvajal, Javier, Fernández, Paula, Langhoff-Roos, Jens, Vélez, Paola, Sultan, Alaa, Teklu, Alula M., Worku, Dawit, Govule, Philip, Noora Lwanga, Charles, Flores Aceituno, María Guadalupe, Bustillo, Carolina, Lara, Bredy, Suri, Vanita, Trikha, Sonia, Cetin, Irene, Personeni, Carlo, Baimussanova, Guldana, Sagyndykova, Balgyn, Gwako, George, Osoti, Alfred, Asylbasheva, Raisa, Seksenbaeva, Damira, Itani, Saad Eddine, Abou Malham, Sabina, Ramašauskaitė, Diana, Chikhwaza, Owen, Malunga, Eddie, Dembele, Haoua, Zerbo, Fanta Eliane, Dávila Serapio, Filiberto, Islas Castañeda, Juan I., Cauaus, Tatiana, Petrov, Victor, Khishgee, Seded, Lkhagvasuren, Bat-Erdene, Essolbi, Amina, Moulki, Rachid, Jaze, Zara, Mariano, Arlete, Maung, Thae Maung, Gurung, Tara, Shrestha, Sangeeta, Rijken, Marcus J., Van Den Akker, Thomas, Estrada, María Esther, Pavón Gómez, Néstor J., Adesina, Olubukola, Aimakhu, Chris, Chaudhri, Rizwana, Khan, M. Adnan, Huatuco Hernández, María del Pilar, Andal, Maria Lu, Martin, Carolina Paula, Diouf, Léopold, Guirassy, Dembo, Borovsky, Miroslav, Kovac, Ladislav, Cornelissen, Laura, Soma-Pillay, Priya, López, Marta, Vidal Benedé, María José, Jayakody, Hemali, Nabag, Wisal, Omer, Sara, Tsoy, Victoria, Uzakova, Urunbish, Tangsiriwatthana, Thumwadee, Dunlop, Catherine, Roman, Jhon, Vitureira, Gerardo, Truong, Luong Ngoc, Hanh, Nghiem Thi Xuan, Madziyire, Mugove, Magwali, Thulani, Bartlett, Linda, Bellissimo-Rodrigues, Fernando, Jacob, Shevin T., Shakoor, Sadia, Yunis, Khalid, Campodónico, Liana, Gamerro, Hugo, Giordano, Daniel, Althabe, Fernando, Gülmezoglu, A. Metin, and Souza, João Paulo

Published
2020
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14. Utilization of Antenatal Care and Pregnancy Outcomes of Women in Advanced Maternal Age at a Tertiary care Hospital in Sri Lanka

Author

Illangasinghe Poojani, Jayaratne Kapila, and Palitha Karunapema

Subjects
Advanced maternal age pregnancy, Adverse pregnancy outcomes of AMA, Contributory factors of AMA, Utilization of antenatal care services
Abstract

Introduction: Childbearing in latter part of reproductive age is challenging. Adverse pregnancy outcomes increase with advanced (>35 years) maternal age (AMA) and comprehensive antenatal care (ANC) usage by AMA women improves their pregnancy outcomes. However, no recent local data are available on the AMA and pregnancy outcomes. Objectives: To describe utilization of ANC and pregnancy outcomes of AMA women delivering at North Colombo Teaching Hospital and assessed the association between utilization of ANC services and selected pregnancy outcomes. Methods: A descriptive cross-sectional study was conducted among 216 women aged >35 years delivered at Colombo North Teaching Hospital selected using a non-probability consecutive sampling method. Women were interviewed within 7 days postpartum inward using an interviewer-administered questionnaire. Selected data were extracted from clinical records. Key elements of ANC (booking visit, type, frequency, services etc.) were scored and their association with pregnancy outcomes were assessed. Results: A total of 216 AMA postpartum women (age range 35–45 years, mean 37.8 (SD=2.4)) were recruited (response rate 100%). Majority (91.7%, n=198) were multiparous. The current pregnancy was planned in 77.8% (n=168) and 52.7% (n=114) experienced antenatal morbidities. Adverse maternal (8.3%, n=18) and newborn (37%, n=80) outcomes were noted. Majority (75.9%, n=164) optimally utilized ANC. Sinhalese (OR=2.98, 95%CI 1.29–6.87, p=0.008), Buddhist (OR=2.53, 95%CI 1.33–4.80, p=0.004) women with intended pregnancies (OR=5.67, 95%CI 2.81–11.43, p Conclusions: Many AMA women are multiparous and with planned pregnancies. Presence of adverse maternal & newborn outcomes is substantial. Majority well utilized ANC and it reduced adverse pregnancy outcomes. Effective strategies should be formulated to promote well-planned pregnancies in early reproductive ages of women.

Published
2023
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15. Perinatal outcomes in twin pregnancies complicated by maternal morbidity: evidence from the WHO Multicountry Survey on Maternal and Newborn Health

Author

Santana, Danielly S., Silveira, Carla, Costa, Maria L., Souza, Renato T., Surita, Fernanda G., Souza, João P., Mazhar, Syeda Batool, Jayaratne, Kapila, Qureshi, Zahida, Sousa, Maria H., Vogel, Joshua P., Cecatti, José G., and on behalf of the WHO Multi-Country Survey on Maternal and Newborn Health Research Network

Published
2018
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16. Clinical practice patterns on the use of magnesium sulphate for treatment of pre‐eclampsia and eclampsia: a multi‐country survey

Author

Long, Q, Oladapo, OT, Leathersich, S, Vogel, JP, Carroli, G, Lumbiganon, P, Qureshi, Z, Gülmezoglu, AM, Mustafa, Lais, Carroli, Guillermo, Cecatti, José, Wolomby‐Molondo, Jean‐José, Roy, Malabika, Sing, Shalini, Mori, Rintaro, Nagata, Chie, Qureshi, Zahida, Panozo, Eduardo, Nafiou, Idi, Fawole, Bukola, Mazhar, Batool, Bataglia, Vicente, Zavaleta, Nelly, Jayaratne, Kapila, and Mugerwa, Kidza

Published
2017
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17. Additional file 1 of International virtual confidential reviews of infection-related maternal deaths and near-miss in 11 low- and middle-income countries – case report series and suggested actions

Author

Okafor, Obiageli, Roos, Nathalie, Abdosh, Abdulfetah Abdulkadir, Adesina, Olubukola, Alaoui, Zaynab, Romero, William Arriaga, Assarag, Bouchra, Aworinde, Olufemi, de Bernis, Luc, Castro, Rigoberto, Chrifi, Hassan, Day, Louise Tina, Demissew, Rahel, Aceituno, María Guadalupe Flores, Gadama, Luis, Gashawbeza, Biruck, Keke, Sourou Goufodji, Govule, Philip, Gwako, George, Jayaratne, Kapila, Komboigo, Evelyne Béwendin, Lara, Bredy, Madziyire, Mugove Gerald, Mathai, Matthews, Moulki, Rachid, Moutaouadia, Iatimad, Munjanja, Stephen, Fletes, Carlos Alberto Ochoa, Ortiz, Edgar Ivan, Ouedraogo, Henri Gautier, Qureshi, Zahida, Recidoro, Zenaida Dy, Senanayake, Hemantha, Soma-Pillay, Priya, Tin, Khaing Nwe, Sedami, Pascal, Worku, Dawit, and Bonet, Mercedes

Abstract

Additional file 1. Supplementary appendix to “International virtual confidential reviews of infection-related maternal deaths and near-miss in 11 low- and middle-income countries – Case report series and suggested actions. Study forms used for data collection and during the external review meetings. Results of a baseline assessment of maternal death review (MDR) committees and practices in participating GLOSS facilities. Additional information on the causes of deaths and distribution of modifiable factors described in this study.

Published
2022
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20. Perinatal outcomes among births to women with infection during pregnancy

Author

Baguiya, Adama, primary, Bonet, Mercedes, additional, Cecatti, José Guilherme, additional, Brizuela, Vanessa, additional, Curteanu, Ala, additional, Minkauskiene, Meile, additional, Jayaratne, Kapila, additional, Ribeiro-do-Valle, Carolina Carvalho, additional, Budianu, Mihaela-Alexandra, additional, Souza, João Paulo, additional, and Kouanda, Séni, additional

Published
2021
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21. Improving the Policy Utility of Cause of Death Statistics in Sri Lanka: An Empirical Investigation of Causes of Out-of-Hospital Deaths Using Automated Verbal Autopsy Methods

Author

Mikkelsen, Lene, primary, de Alwis, Sunil, additional, Sathasivam, Sridharan, additional, Kumarapeli, Vindya, additional, Tennakoon, Ajith, additional, Karunapema, Palitha, additional, Jayaratne, Kapila, additional, Jayasuriya, Rajitha, additional, Gamage, Saman, additional, Hewapathirana, Roshan, additional, Wadugedara, Rangana, additional, Dissanayake, Manoj, additional, Senanayake, Chamika H., additional, Mahesh, Pasyodun Koralage Buddhika, additional, McLaughlin, Deirdre, additional, and Lopez, Alan D., additional

Published
2021
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22. Frequency and management of maternal infection in health facilities in 52 countries (GLOSS): a 1-week inception cohort study

Author

Geboortecentrum voorzitterschap, Child Health, MS Verloskunde, Bonet, Mercedes, Brizuela, Vanessa, Abalos, Edgardo, Cuesta, Cristina, Baguiya, Adama, Chamillard, Mónica, Fawole, Bukola, Knight, Marian, Kouanda, Seni, Lumbiganon, Pisake, Nabhan, Ashraf, Nadisauskiene, Ruta J., Abdulkadir, Abdulfetah, Adanu, Richard MK, Aman, Mohammad Iqbal, Arriaga Romero, William E., Assarag, Bouchra, Bloemenkamp, Kitty W.M., Boobekova, Aigul, Budianu, Mihaela A., Cararach, Vicenç, Castro, Rigoberto, Cebekhulu, Sylvia, Cecatti, José Guilherme, Colmorn, Lotte Berdiin, Curteanu, Ala, Donati, Serena, Einda, Hla Mya Thway, El Deen, Yasser Salah, El Kak, Faysal, Elsheikh, Mohamed, Escobar-Vidarte, Maria F., Espinoza, Marisa Mabel, Estrada, María Ester, Gadama, Luis Aaron, Goufodji, Sourou B., Hamid, Saima, Hernandez Munoz, Rosalinda, Herrera Maldonado, Nazarea, Jayaratne, Kapila, Kabylova, Saule, Kristufkova, Alexandra, Kumar, Vijay, Lissauer, David, Mereci, Wilson, Minkauskiene, Meile, Moreira, Philippe, Munjanja, Stephen, Osman, Nafissa B., Rijken, Marcus J., Geboortecentrum voorzitterschap, Child Health, MS Verloskunde, Bonet, Mercedes, Brizuela, Vanessa, Abalos, Edgardo, Cuesta, Cristina, Baguiya, Adama, Chamillard, Mónica, Fawole, Bukola, Knight, Marian, Kouanda, Seni, Lumbiganon, Pisake, Nabhan, Ashraf, Nadisauskiene, Ruta J., Abdulkadir, Abdulfetah, Adanu, Richard MK, Aman, Mohammad Iqbal, Arriaga Romero, William E., Assarag, Bouchra, Bloemenkamp, Kitty W.M., Boobekova, Aigul, Budianu, Mihaela A., Cararach, Vicenç, Castro, Rigoberto, Cebekhulu, Sylvia, Cecatti, José Guilherme, Colmorn, Lotte Berdiin, Curteanu, Ala, Donati, Serena, Einda, Hla Mya Thway, El Deen, Yasser Salah, El Kak, Faysal, Elsheikh, Mohamed, Escobar-Vidarte, Maria F., Espinoza, Marisa Mabel, Estrada, María Ester, Gadama, Luis Aaron, Goufodji, Sourou B., Hamid, Saima, Hernandez Munoz, Rosalinda, Herrera Maldonado, Nazarea, Jayaratne, Kapila, Kabylova, Saule, Kristufkova, Alexandra, Kumar, Vijay, Lissauer, David, Mereci, Wilson, Minkauskiene, Meile, Moreira, Philippe, Munjanja, Stephen, Osman, Nafissa B., and Rijken, Marcus J.

Published
2020

24. Continuing maternal and child health (MCH) services during COVID-19: activities, challenges and the lessons learnt

Author

De Silva, Chithramalee, primary, Batuwanthudawe, Ranjith, additional, Lokubalasooriya, Ayesha, additional, Jayaratne, Kapila, additional, Mapitigama, Nethanjalie, additional, Moonasinghe, Loshan, additional, Kasturiaratchi, Kaushalya, additional, Vithana, Chiranthika, additional, Godakandage, Sanjeewa, additional, Jayawickrama, Hiranya, additional, Thenuwara, Nethmini, additional, Thalagala, Neil, additional, De Silva, Dileep, additional, Fonseka, Nishani, additional, Perera, Nadeeka, additional, Ambagahawita, Anjana, additional, Ariyadasa, Gayan, additional, and Perera, E. Madhurangi, additional

Published
2020
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28. Mode of delivery and pregnancy outcomes in preterm birth: a secondary analysis of the WHO Global and Multi-country Surveys

Author

Thanh, Bao Yen Luong, primary, Lumbiganon, Pisake, additional, Pattanittum, Porjai, additional, Laopaiboon, Malinee, additional, Vogel, Joshua P., additional, Oladapo, Olufemi T., additional, Pileggi-Castro, Cynthia, additional, Mori, Rintaro, additional, Jayaratne, Kapila, additional, Qureshi, Zahida, additional, and Souza, Joã, additional

Published
2019
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31. Child Health Partnerships: a review of program characteristics, outcomes and their relationship

Author

Jayaratne Kapila, Kelaher Margaret, and Dunt David

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background Novel approaches are increasingly employed to address the social determinants of health of children world-wide. Such approaches have included complex social programs involving multiple stakeholders from different sectors jointly working together (hereafter Child Health Partnerships). Previous reviews have questioned whether these programs have led to significant improvements in child health and related outcomes. We aim to provide definitive answers to this question as well as identifying the characteristics of successful partnerships. Methods A comprehensive literature search identified 11 major Child Health Partnerships in four comparable developed countries. A critical review is focused on various aspects of these including their target groups, program mechanics and outcomes. Results and Conclusions There was evidence of success in several major areas from the formation of effective joint operations of partners in different partnership models to improvement in both child wellbeing and parenting. There is emerging evidence that Child Health Partnerships are cost-effective. Population characteristics and local contexts need to be taken into account in the introduction and implementation of these programs.

Published
2010
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32. Increases in Caesarean Delivery Rates and Change of Perinatal Outcomes in Low- and Middle-Income Countries: A Hospital-Level Analysis of Two WHO Surveys

Author

Zhao, Yanjun, primary, Zhang, Jun, additional, Zamora, Javier, additional, Vogel, Joshua Peter, additional, Souza, João P., additional, Jayaratne, Kapila, additional, Ganchimeg, Togoobaatar, additional, Ortiz-Panozo, Eduardo, additional, Hernandez, Bernardo, additional, Oladapo, Olufemi T., additional, Torloni, Maria R., additional, Morisaki, Naho, additional, Mori, Rintaro, additional, Pileggi-Castro, Cynthia, additional, Tunçalp, Özge, additional, Shen, Xiaoming, additional, and Betrán, Ana Pilar, additional

Published
2017
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33. Incidence and outcomes of uterine rupture among women with prior caesarean section: WHO Multicountry Survey on Maternal and Newborn Health

Author

Motomura, Kenichiro, primary, Ganchimeg, Togoobaatar, additional, Nagata, Chie, additional, Ota, Erika, additional, Vogel, Joshua P., additional, Betran, Ana Pilar, additional, Torloni, Maria Regina, additional, Jayaratne, Kapila, additional, Jwa, Seung Chik, additional, Mittal, Suneeta, additional, Dy Recidoro, Zenaida, additional, Matsumoto, Kenji, additional, Fujieda, Mikiya, additional, Nafiou, Idi, additional, Yunis, Khalid, additional, Qureshi, Zahida, additional, Souza, Joao Paulo, additional, and Mori, Rintaro, additional

Published
2017
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34. Searching for the definition of macrosomia through an outcome-based approach in low- and middle-income countries: a secondary analysis of the WHO Global Survey in Africa, Asia and Latin America

Author

Ye, Jiangfeng, primary, Torloni, Maria Regina, additional, Ota, Erika, additional, Jayaratne, Kapila, additional, Pileggi-Castro, Cynthia, additional, Ortiz-Panozo, Eduardo, additional, Lumbiganon, Pisake, additional, Morisaki, Naho, additional, Laopaiboon, Malinee, additional, Mori, Rintaro, additional, Tunçalp, Özge, additional, Fang, Fang, additional, Yu, Hongping, additional, Souza, João Paulo, additional, Vogel, Joshua Peter, additional, and Zhang, Jun, additional

Published
2015
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35. Moving beyond essential interventions for reduction of maternal mortality (the WHO Multicountry Survey on Maternal and Newborn Health) : a cross-sectional study

Author

Souza, João Paulo, Gülmezoglu, Ahmet Metin, Vogel, Joshua, Carroli, Guillermo, Lumbiganon, Pisake, Qureshi, Zahida, Costa, Maria José, Fawole, Bukola, Mugerwa, Yvonne, Nafiou, Idi, Neves, Isilda, Wolomby-Molondo, Jean-José, Bang, Hoang Thi, Cheang, Kannitha, Chuyun, Kang, Jayaratne, Kapila, Jayathilaka, Chandani Anoma, Mazhar, Syeda Batool, Mori, Rintaro, Mustafa, Mir Lais, Pathak, Laxmi Raj, Perera, Deepthi, Rathavy, Tung, Recidoro, Zenaida, Roy, Malabika, Ruyan, Pang, Shrestha, Naveen, Taneepanichsku, Surasak, Tien, Nguyen Viet, Ganchimeg, Togoobaatar, Wehbe, Mira, Yadamsuren, Buyanjargal, Yan, Wang, Yunis, Khalid, Bataglia, Vicente, Cecatti, José Guilherme, Hernandez-Prado, Bernardo, Nardin, Juan Manuel, Narváez, Alberto, Ortiz-Panozo, Eduardo, Pérez-Cuevas, Ricardo, Valladares, Eliette, Zavaleta, Nelly, Armson, Anthony, Crowther, Caroline, Hogue, Carol, Lindmark, Gunilla, Mittal, Suneeta, Pattinson, Robert, Stanton, Mary Ellen, Campodonico, Liana, Cuesta, Cristina, Giordano, Daniel, Intarut, Nirun, Laopaiboon, Malinee, Bahl, Rajiv, Martines, Jose, Mathai, Matthews, Merialdi, Mario, Say, Lale, Souza, João Paulo, Gülmezoglu, Ahmet Metin, Vogel, Joshua, Carroli, Guillermo, Lumbiganon, Pisake, Qureshi, Zahida, Costa, Maria José, Fawole, Bukola, Mugerwa, Yvonne, Nafiou, Idi, Neves, Isilda, Wolomby-Molondo, Jean-José, Bang, Hoang Thi, Cheang, Kannitha, Chuyun, Kang, Jayaratne, Kapila, Jayathilaka, Chandani Anoma, Mazhar, Syeda Batool, Mori, Rintaro, Mustafa, Mir Lais, Pathak, Laxmi Raj, Perera, Deepthi, Rathavy, Tung, Recidoro, Zenaida, Roy, Malabika, Ruyan, Pang, Shrestha, Naveen, Taneepanichsku, Surasak, Tien, Nguyen Viet, Ganchimeg, Togoobaatar, Wehbe, Mira, Yadamsuren, Buyanjargal, Yan, Wang, Yunis, Khalid, Bataglia, Vicente, Cecatti, José Guilherme, Hernandez-Prado, Bernardo, Nardin, Juan Manuel, Narváez, Alberto, Ortiz-Panozo, Eduardo, Pérez-Cuevas, Ricardo, Valladares, Eliette, Zavaleta, Nelly, Armson, Anthony, Crowther, Caroline, Hogue, Carol, Lindmark, Gunilla, Mittal, Suneeta, Pattinson, Robert, Stanton, Mary Ellen, Campodonico, Liana, Cuesta, Cristina, Giordano, Daniel, Intarut, Nirun, Laopaiboon, Malinee, Bahl, Rajiv, Martines, Jose, Mathai, Matthews, Merialdi, Mario, and Say, Lale

Abstract

BACKGROUND: We report the main findings of the WHO Multicountry Survey on Maternal and Newborn Health (WHOMCS), which aimed to assess the burden of complications related to pregnancy, the coverage of key maternal health interventions, and use of the maternal severity index (MSI) in a global network of health facilities. METHODS: In our cross-sectional study, we included women attending health facilities in Africa, Asia, Latin America, and the Middle East that dealt with at least 1000 childbirths per year and had the capacity to provide caesarean section. We obtained data from analysis of hospital records for all women giving birth and all women who had a severe maternal outcome (SMO; ie, maternal death or maternal near miss). We regarded coverage of key maternal health interventions as the proportion of the target population who received an indicated intervention (eg, the proportion of women with eclampsia who received magnesium sulphate). We used areas under the receiver operator characteristic curves (AUROC) with 95% CI to externally validate a previously reported MSI as an indicator of severity. We assessed the overall performance of care (ie, the ability to produce a positive effect on health outcomes) through standardised mortality ratios. RESULTS: From May 1, 2010, to Dec 31, 2011, we included 314,623 women attending 357 health facilities in 29 countries (2538 had a maternal near miss and 486 maternal deaths occurred). The mean period of data collection in each health facility was 89 days (SD 21). 23,015 (7.3%) women had potentially life-threatening disorders and 3024 (1.0%) developed an SMO. 808 (26.7%) women with an SMO had post-partum haemorrhage and 784 (25.9%) had pre-eclampsia or eclampsia. Cardiovascular, respiratory, and coagulation dysfunctions were the most frequent organ dysfunctions in women who had an SMO. Reported mortality in countries with a high or very high maternal mortality ratio was two-to-three-times higher than that expected for the asse, FUNDING: UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP); WHO; USAID; Ministry of Health, Labour and Welfare of Japan; Gynuity Health Projects.

Published
2013
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36. Surveillance and response system for maternal deaths in Sri Lanka: an audit

Author

Jayaratne Kapila and Perera Deepthi

Subjects
business.industry, Service delivery framework, General Medicine, Audit, medicine.disease, Health facility, Family planning, Environmental health, Health care, medicine, Maternal death, Medical emergency, Sri lanka, business, Response system
Abstract

Background Many women in low-income countries die from pregnancy-related causes. Review of maternal deaths can help to prevent such deaths and improve delivery of maternal care services, but audits of maternal deaths are not easy to do in resource-poor settings. We audited probable maternal deaths reported during 2012 in Sri Lanka. Methods We analysed data for death collected by the Family Health Bureau, which coordinates audits of maternal death in Sri Lanka. Field and hospital health staff are required to notify deaths, do post mortems, investigate, and report to national level each maternal death. We analysed each death related to three delays: in seeking health care, in reaching a health facility, and in treatment. We asked health-care workers in 26 districts to suggest strategies to change and improve service delivery. Findings Of 218 probable maternal deaths, we classified 134 as maternal deaths (WHO definition) and calculated the national maternal mortality rate (37·7 per 100 000 live births). Haemorrhage (n=22) and heart disease (n=15) were leading causes of death. Women who died tended to be well educated (n=109, 81%) and from rural regions (n=106, 79%). 92 (69%) of these women died in the postnatal period. Delays in seeking health care contributed to 64 deaths (71%), whereas delays in receiving treatment contributed to 54 (60%) and delays in reaching a health facility contributed to two (2%). Not promoting family planning, substandard management, and inadequate field post-natal care were identified as deficiencies. Interpretation Sri Lanka implements a systematic surveillance of maternal deaths at low cost, with involvement of key partners to further reduce deaths and improve care. Such a system is replicable in any setting if launched methodically and in collaboration with committed partners. Funding None.

Published
2014

37. Moving beyond essential interventions for reduction of maternal mortality (the WHO Multicountry Survey on Maternal and Newborn Health): a cross-sectional study

Author

Souza, João Paulo, primary, Gülmezoglu, Ahmet Metin, additional, Vogel, Joshua, additional, Carroli, Guillermo, additional, Lumbiganon, Pisake, additional, Qureshi, Zahida, additional, Costa, Maria José, additional, Fawole, Bukola, additional, Mugerwa, Yvonne, additional, Nafiou, Idi, additional, Neves, Isilda, additional, Wolomby-Molondo, Jean-José, additional, Bang, Hoang Thi, additional, Cheang, Kannitha, additional, Chuyun, Kang, additional, Jayaratne, Kapila, additional, Jayathilaka, Chandani Anoma, additional, Mazhar, Syeda Batool, additional, Mori, Rintaro, additional, Mustafa, Mir Lais, additional, Pathak, Laxmi Raj, additional, Perera, Deepthi, additional, Rathavy, Tung, additional, Recidoro, Zenaida, additional, Roy, Malabika, additional, Ruyan, Pang, additional, Shrestha, Naveen, additional, Taneepanichsku, Surasak, additional, Tien, Nguyen Viet, additional, Ganchimeg, Togoobaatar, additional, Wehbe, Mira, additional, Yadamsuren, Buyanjargal, additional, Yan, Wang, additional, Yunis, Khalid, additional, Bataglia, Vicente, additional, Cecatti, José Guilherme, additional, Hernandez-Prado, Bernardo, additional, Nardin, Juan Manuel, additional, Narváez, Alberto, additional, Ortiz-Panozo, Eduardo, additional, Pérez-Cuevas, Ricardo, additional, Valladares, Eliette, additional, Zavaleta, Nelly, additional, Armson, Anthony, additional, Crowther, Caroline, additional, Hogue, Carol, additional, Lindmark, Gunilla, additional, Mittal, Suneeta, additional, Pattinson, Robert, additional, Stanton, Mary Ellen, additional, Campodonico, Liana, additional, Cuesta, Cristina, additional, Giordano, Daniel, additional, Intarut, Nirun, additional, Laopaiboon, Malinee, additional, Bahl, Rajiv, additional, Martines, Jose, additional, Mathai, Matthews, additional, Merialdi, Mario, additional, and Say, Lale, additional

Published
2013
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38. Optimal Timing of Delivery among Low-Risk Women with Prior Caesarean Section: A Secondary Analysis of the WHO Multicountry Survey on Maternal and Newborn Health.

Author

Ganchimeg, Togoobaatar, Nagata, Chie, Vogel, Joshua P., Morisaki, Naho, Pileggi-Castro, Cynthia, Ortiz-Panozo, Eduardo, Jayaratne, Kapila, Mittal, Suneeta, Ota, Erika, Souza, João Paulo, Mori, Rintaro, and null, null

Subjects
CESAREAN section, HEALTH surveys, DELIVERY (Obstetrics), HEALTH outcome assessment
Abstract

Objective: To investigate optimal timing of elective repeat caesarean section among low-risk pregnant women with prior caesarean section in a multicountry sample from largely low- and middle-income countries. Design: Secondary analysis of a cross-sectional study. Setting: Twenty-nine countries from the World Health Organization Multicountry Survey on Maternal and Newborn Health. Population: 29,647 women with prior caesarean section and no pregnancy complications in their current pregnancy who delivered a term singleton (live birth and stillbirth) at gestational age 37–41 weeks by pre-labour caesarean section, intra-partum caesarean section, or vaginal birth following spontaneous onset of labour. Methods: We compared the rate of short-term adverse maternal and newborn outcomes following pre-labour caesarean section at a given gestational age, to those following ongoing pregnancies beyond that gestational age. Main Outcome Measures: Severe maternal outcomes, neonatal morbidity, and intra-hospital early neonatal mortality. Results: Odds of neonatal morbidity and intra-hospital early neonatal mortality were 0.48 (95% confidence interval [CI] 0.39–0.60) and 0.31 (95% CI 0.16–0.58) times lower for ongoing pregnancies compared to pre-labour caesarean section at 37 weeks. We did not find any significant change in the risk of severe maternal outcomes between pre-labour caesarean section at a given gestational age and ongoing pregnancies beyond that gestational age. Conclusions: Elective repeat caesarean section at 37 weeks had higher risk of neonatal morbidity and mortality compared to ongoing pregnancy, however risks at later gestational ages did not differ between groups. [ABSTRACT FROM AUTHOR]

Published
2016
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39. Searching for the definition of macrosomia through an outcome-based approach in low- and middle-income countries: a secondary analysis of the WHO Global Survey in Africa, Asia and Latin America.

Author

Jiangfeng Ye, Torloni, Maria Regina, Ota, Erika, Jayaratne, Kapila, Pileggi-Castro, Cynthia, Ortiz-Panozo, Eduardo, Lumbiganon, Pisake, Morisaki, Naho, Laopaiboon, Malinee, Mori, Rintaro, Tunçalp, Özge, Fang Fang, Hongping Yu, Souza, João Paulo, Vogel, Joshua Peter, Jun Zhang, Ye, Jiangfeng, Fang, Fang, Yu, Hongping, and Zhang, Jun

Subjects
GESTATIONAL age, SURVEYS, DATA analysis, LOW-income countries, MIDDLE-income countries, POVERTY areas, COMPARATIVE studies, DATABASES, DISEASES, INFANT mortality, RESEARCH methodology, MEDICAL cooperation, MATERNAL mortality, DURATION of pregnancy, RESEARCH, LOGISTIC regression analysis, EVALUATION research, FETAL macrosomia, ODDS ratio, DIAGNOSIS
Abstract

Background: No consensus definition of macrosomia currently exists among researchers and obstetricians. We aimed to identify a definition of macrosomia that is more predictive of maternal and perinatal mortality and morbidity in low- and middle-income countries.Methods: We conducted a secondary data analysis using WHO Global Survey on Maternal and Perinatal Health data on Africa and Latin America from 2004 to 2005 and Asia from 2007 to 2008. We compared adverse outcomes, which were assessed by the composite maternal mortality and morbidity index (MMMI) and perinatal mortality and morbidity index (PMMI) in subgroups with birthweight (3000-3499 g [reference group], 3500-3999 g, 4000-4099 g, 4100-4199 g, 4200-4299 g, 4300-4399 g, 4400-4499 g, 4500-4999 g) or country-specific birthweight percentile for gestational age (50(th)-74(th) percentile [reference group], 75(th)-89(th), 90(th)-94(th), 95(th)-96(th), and ≥97(th) percentile). Two-level logistic regression models were used to estimate odds ratios of MMMI and PMMI.Results: A total of 246,659 singleton term births from 363 facilities in 23 low- and middle-income countries were included. Adjusted odds ratios (aORs) for intrapartum caesarean sections exceeded 2.0 when birthweight was greater than 4000 g (2·00 [95% CI: 1·68, 2·39], 2·42 [95% CI: 2·02, 2·89], 2·01 [95% CI: 1·74, 2·33] in Africa, Asia and Latin America, respectively). aORs of MMMI reached 2.0 when birthweight was greater than 4000 g, 4500 g in Asia and Africa, respectively. aORs of PMMI approached to 2.0 (1·78 [95% CI: 1·16, 2·74]) when birthweight was greater than 4500 g in Latin America. When birthweight was at the 90(th) percentile or higher, aORs of MMMI and PMMI increased, but none exceeded 2.0.Conclusions: The population-specific definition of macrosomia using birthweight cut-off points irrespective of gestational age (4500 g in Africa and Latin America, 4000 g in Asia) is more predictive of maternal and perinatal adverse outcomes, and simpler to apply compared to the definition based on birthweight percentile for a given gestational age. [ABSTRACT FROM AUTHOR]

Published
2015
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43. Child Health Partnerships: a review of programcharacteristics, outcomes and their relationship.

Author

Jayaratne, Kapila, Kelaher, Margaret, and Dunt, David

Subjects
CHILDREN'S health, BUSINESS partnerships, PUBLIC health, CHILD rearing, DEVELOPED countries
Abstract

Background: Novel approaches are increasingly employed to address the social determinants of health of children world-wide. Such approaches have included complex social programs involving multiple stakeholders from different sectors jointly working together (hereafter Child Health Partnerships). Previous reviews have questioned whether these programs have led to significant improvements in child health and related outcomes. We aim to provide definitive answers to this question as well as identifying the characteristics of successful partnerships. Methods: A comprehensive literature search identified 11 major Child Health Partnerships in four comparable developed countries. A critical review is focused on various aspects of these including their target groups, program mechanics and outcomes. Results and Conclusions: There was evidence of success in several major areas from the formation of effective joint operations of partners in different partnership models to improvement in both child wellbeing and parenting. There is emerging evidence that Child Health Partnerships are cost-effective. Population characteristics and local contexts need to be taken into account in the introduction and implementation of these programs. [ABSTRACT FROM AUTHOR]

Published
2010
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44. Sri Lanka: Adding Ergonomics Dimension in the Health Agenda.

Author

Jayaratne, Kapila, Danansuriya, Manjula, and De Silva, Chamaine

Subjects
ERGONOMICS, MEDICAL societies, SERIAL publications, DEMOGRAPHIC characteristics
Abstract

The authors reflect on the important role played by the organization Sri Lanka Medical Association (SLMA) in leading the promotion of ergonomics in Sri Lanka. They provide overview of population dynamics, economic development, and health achievements of the country, and how ergonomics have penetrated enormously in several fields. The authors also commend the effort of the SLMA in providing local experts working in different ergonomic scenarios to publicize their work and experience.

Published
2016
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45. Obstetric transition in the World Health Organization Multicountry Survey on Maternal and Newborn Health: Exploring pathways for maternal mortality reduction

Author

Chaves, Solange Da Cruz, Cecatti, Jose Guilherme, Carroli, Guillermo, Lumbiganon, Pisake, Hogue, Carol J., Mori, Rintaro, Zhang, Jun, Jayaratne, Kapila, Togoobaatar, Ganchimeg, Pileggi-Castro, Cynthia, Bohren, Meghan, Vogel, Joshua Peter, Tuncalp, Ozge, Oladapo, Olufemi Taiwo, Gulmezoglu, Ahmet Metin, Temmerman, Marleen, and João Paulo Souza

Subjects
Adult, lcsh:Arctic medicine. Tropical medicine, Salud de la mujer, lcsh:RC955-962, Maternal-Child Health Centers, lcsh:Medicine, Global Health, World Health Organization, salud global, Young Adult, Pregnancy, bienestar materno, Infant Mortality, Humans, Infant Health, Labor, Induced, Developing Countries, Cesarean Section, complicaciones del trabajo de parto, lcsh:Public aspects of medicine, lcsh:R, Organización Mundial de la Salud, Infant, Newborn, Pregnancy Outcome, Infant, lcsh:RA1-1270, Stillbirth, Delivery, Obstetric, Primary Prevention, Cross-Sectional Studies, Fertility, Maternal Mortality, Socioeconomic Factors, Health Care Surveys, Medicalization, mortalidad materna, tendencias, Female, Maternal Age
Abstract

OBJECTIVE: To test whether the proposed features of the Obstetric Transition Model-a theoretical framework that may explain gradual changes that countries experience as they eliminate avoidable maternal mortality-are observed in a large, multicountry, maternal and perinatal health database; and to discuss the dynamic process of maternal mortality reduction using this model as a theoretical framework. METHODS: This was a secondary analysis of a cross-sectional study by the World Health Organization that collected information on more than 300 000 women who delivered in 359 health facilities in 29 countries in Africa, Asia, Latin America, and the Middle East, during a 2-4-month period in 2010-2011. The ratios of Potentially Life-Threatening Conditions, Severe Maternal Outcomes, Maternal Near Miss, and Maternal Death were estimated and stratified by stages of obstetric transition. The characteristics of each stage are defined. RESULTS: Data from 314 623 women showed that female fertility, indirectly estimated by parity, was higher in countries at a lower obstetric transition stage, ranging from a mean of 3 children in Stage II to 1.8 children in Stage IV. Medicalization increased with obstetric transition stage. In Stage IV, women had 2.4 times the cesarean deliveries (15.3% in Stage II and 36.7% in Stage IV) and 2.6 times the labor inductions (7.1% in Stage II and 18.8% in Stage IV) as women in Stage II. The mean age of primiparous women also increased with stage. The occurrence of uterine rupture had a decreasing trend, dropping by 5.2 times, from 178 to 34 cases per 100 000 live births, as a country transitioned from Stage II to IV. CONCLUSIONS: This analysis supports the concept of obstetric transition using multicountry data. The Obstetric Transition Model could provide justification for customizing strategies for reducing maternal mortality according to a country's stage in the obstetric transition.

46. Obstetric transition in the World Health Organization Multicountry Survey on Maternal and Newborn Health: exploring pathways for maternal mortality reduction.

Author

da Cruz Chaves, Solange, Cecatti, José Guilherme, Carroli, Guillermo, Lumbiganon, Pisake, Hogue, Carol J., Rintaro Mori, Jun Zhang, Jayaratne, Kapila, Togoobaatar, Ganchimeg, Pileggi-Castro, Cynthia, Bohren, Meghan, Vogel, Joshua Peter, Tunçalp, Özge, Oladapo, Olufemi Taiwo, Gülmezoglu, Ahmet Metin, Temmerman, Marleen, and Souza, João Paulo

Abstract

Objective. To test whether the proposed features of the Obstetric Transition Model--a theoretical framework that may explain gradual changes that countries experience as they eliminate avoidable maternal mortality--are observed in a large, multicountry, maternal and perinatal health database; and to discuss the dynamic process of maternal mortality reduction using this model as a theoretical framework. Methods. This was a secondary analysis of a cross-sectional study by the World Health Organization that collected information on more than 300 000 women who delivered in 359 health facilities in 29 countries in Africa, Asia, Latin America, and the Middle East, during a 2-4-month period in 2010-2011. The ratios of Potentially Life-Threatening Conditions, Severe Maternal Outcomes, Maternal Near Miss, and Maternal Death were estimated and stratified by stages of obstetric transition. The characteristics of each stage are defined. Results. Data from 314 623 women showed that female fertility, indirectly estimated by parity, was higher in countries at a lower obstetric transition stage, ranging from a mean of 3 children in Stage II to 1.8 children in Stage IV. Medicalization increased with obstetric transition stage. In Stage IV, women had 2.4 times the cesarean deliveries (15.3% in Stage II and 36.7% in Stage IV) and 2.6 times the labor inductions (7.1% in Stage II and 18.8% in Stage IV) as women in Stage II. The mean age of primiparous women also increased with stage. The occurrence of uterine rupture had a decreasing trend, dropping by 5.2 times, from 178 to 34 cases per 100 000 live births, as a country transitioned from Stage II to IV. Conclusions. This analysis supports the concept of obstetric transition using multicountry data. The Obstetric Transition Model could provide justification for customizing strategies for reducing maternal mortality according to a country's stage in the obstetric transition. [ABSTRACT FROM AUTHOR]

Published
2015
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47. Obstetric transition in the World Health Organization Multicountry Survey on Maternal and Newborn Health: exploring pathways for maternal mortality reduction.

Author

Chaves Sda C, Cecatti JG, Carroli G, Lumbiganon P, Hogue CJ, Mori R, Zhang J, Jayaratne K, Togoobaatar G, Pileggi-Castro C, Bohren M, Vogel JP, Tunçalp Ö, Oladapo OT, Gülmezoglu AM, Temmerman M, and Souza JP

Subjects
Adult, Cesarean Section statistics & numerical data, Cross-Sectional Studies, Delivery, Obstetric trends, Developing Countries, Female, Fertility, Global Health, Health Care Surveys, Humans, Infant, Infant Mortality trends, Infant, Newborn, Labor, Induced statistics & numerical data, Maternal Age, Maternal-Child Health Centers statistics & numerical data, Medicalization trends, Pregnancy, Pregnancy Outcome, Primary Prevention, Socioeconomic Factors, Stillbirth epidemiology, World Health Organization, Young Adult, Delivery, Obstetric statistics & numerical data, Infant Health trends, Maternal Mortality trends
Abstract

Objective: To test whether the proposed features of the Obstetric Transition Model-a theoretical framework that may explain gradual changes that countries experience as they eliminate avoidable maternal mortality-are observed in a large, multicountry, maternal and perinatal health database; and to discuss the dynamic process of maternal mortality reduction using this model as a theoretical framework., Methods: This was a secondary analysis of a cross-sectional study by the World Health Organization that collected information on more than 300 000 women who delivered in 359 health facilities in 29 countries in Africa, Asia, Latin America, and the Middle East, during a 2-4-month period in 2010-2011. The ratios of Potentially Life-Threatening Conditions, Severe Maternal Outcomes, Maternal Near Miss, and Maternal Death were estimated and stratified by stages of obstetric transition. The characteristics of each stage are defined., Results: Data from 314 623 women showed that female fertility, indirectly estimated by parity, was higher in countries at a lower obstetric transition stage, ranging from a mean of 3 children in Stage II to 1.8 children in Stage IV. Medicalization increased with obstetric transition stage. In Stage IV, women had 2.4 times the cesarean deliveries (15.3% in Stage II and 36.7% in Stage IV) and 2.6 times the labor inductions (7.1% in Stage II and 18.8% in Stage IV) as women in Stage II. The mean age of primiparous women also increased with stage. The occurrence of uterine rupture had a decreasing trend, dropping by 5.2 times, from 178 to 34 cases per 100 000 live births, as a country transitioned from Stage II to IV., Conclusions: This analysis supports the concept of obstetric transition using multicountry data. The Obstetric Transition Model could provide justification for customizing strategies for reducing maternal mortality according to a country's stage in the obstetric transition.

Published
2015

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