Back to Search Start Over

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

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

Authors :
Vanessa Brizuela
Cristina Cuesta
Gino Bartolelli
Abdulfetah Abdulkadir Abdosh
Sabina Abou Malham
Bouchra Assarag
Rigoberto Castro Banegas
Virginia Díaz
Faysal El-Kak
Mohamed El Sheikh
Aquilino M Pérez
João Paulo Souza
Mercedes Bonet
Edgardo Abalos
Rigoberto Castro
Faysal El Kak
Mohamed Elsheikh
Aquilino M. Pérez
Mohammad Iqbal Aman
Bashir Noormal
Marisa Espinoza
Julia Pasquale
Charlotte Leroy
Kristien Roelens
Griet Vandenberghe
M. Christian Urlyss Agossou
Sourou Goufodji Keke
Christiane Tshabu Aguemon
Patricia Soledad Apaza Peralta
Víctor Conde Altamirano
Rosalinda Hernández Muñoz
José Guilherme Cecatti
Carolina Ribeiro do Valle
Vincent Batiene
Kadari Cisse
Henri Gautier Ouedraogo
Kannitha Cheang
Phirun Lam
Tung Rathavy
Elie Simo
Pierre-Marie Tebeu
Emah Irene Yakana
Javier Carvajal
María Fernanda Escobar
Paula Fernández
Lotte Berdiin Colmorn
Jens Langhoff-Roos
Wilson Mereci
Paola Vélez
Yasser Salah Eldin
Alaa Sultan
Alula M. Teklu
Dawit Worku
Richard Adanu
Philip Govule
Charles Noora Lwanga
William Enrique Arriaga Romero
María Guadalupe Flores Aceituno
Carolina Bustillo
Bredy Lara
Vijay Kumar
Vanita Suri
Sonia Trikha
Irene Cetin
Serena Donati
Carlo Personeni
Guldana Baimussanova
Saule Kabylova
Balgyn Sagyndykova
George Gwako
Alfred Osoti
Zahida Qureshi
Raisa Asylbasheva
Aigul Boobekova
Damira Seksenbaeva
Saad Eddine Itani
Meilė Minkauskienė
Diana Ramašauskaitė
Owen Chikhwaza
Luis Gadama
Eddie Malunga
Haoua Dembele
Hamadoun Sangho
Fanta Eliane Zerbo
Filiberto Dávila Serapio
Nazarea Herrera Maldonado
Juan I. Islas Castañeda
Tatiana Cauaus
Ala Curteanu
Victor Petrov
Yadamsuren Buyanjargal
Seded Khishgee
Bat-Erdene Lkhagvasuren
Amina Essolbi
Rachid Moulki
Zara Jaze
Arlete Mariano
Nafissa Bique Osman
Hla Mya Thway Einda
Thae Maung Maung
Khaing Nwe Tin
Tara Gurung
Amir Babu Shrestha
Sangeeta Shrestha
Kitty Bloemenkamp
Marcus J. Rijken
Thomas Van Den Akker
María Esther Estrada
Néstor J. Pavón Gómez
Olubukola Adesina
Chris Aimakhu
Bukola Fawole
Rizwana Chaudhri
Saima Hamid
M. Adnan Khan
María del Pilar Huatuco Hernández
Nelly M. Zavaleta Pimentel
Maria Lu Andal
Zenaida Dy Recidoro
Carolina Paula Martin
Mihaela Budianu
Lucian Puşcaşiu
Léopold Diouf
Dembo Guirassy
Philippe Marc Moreira
Miroslav Borovsky
Ladislav Kovac
Alexandra Kristufkova
Sylvia Cebekhulu
Laura Cornelissen
Priya Soma-Pillay
Vicenç Cararach
Marta López
María José Vidal Benedé
Hemali Jayakody
Kapila Jayaratne
Dhammica Rowel
Wisal Nabag
Sara Omer
Victoria Tsoy
Urunbish Uzakova
Dilrabo Yunusova
Thitiporn Siriwachirachai
Thumwadee Tangsiriwatthana
Catherine Dunlop
Marian Knight
David Lissauer
Jhon Roman
Gerardo Vitureira
Dinh Anh Tuan
Luong Ngoc Truong
Nghiem Thi Xuan Hanh
Mugove Madziyire
Thulani Magwali
Stephen Munjanja
Adama Baguiya
Mónica Chamillard
Seni Kouanda
Pisake Lumbiganon
Ashraf Nabhan
Ruta Nadisauskiene
Linda Bartlett
Fernando Bellissimo-Rodrigues
Shevin T. Jacob
Sadia Shakoor
Khalid Yunis
Liana Campodónico
Hugo Gamerro
Daniel Giordano
Fernando Althabe
A. Metin Gülmezoglu
Obstetrics and Gynaecology
Source :
LANCET GLOBAL HEALTH, lancet global health, 9(9), e1252-e1261. Elsevier BV, The Lancet. Global Health
Publication Year :
2021

Abstract

Background Infections are among the leading causes of maternal mortality and morbidity. The Global Maternal Sepsis and Neonatal Initiative, launched in 2016 by WHO and partners, sought to reduce the burden of maternal infections and sepsis and was the basis upon which the Global Maternal Sepsis Study (GLOSS) was implemented in 2017. In this Article, we aimed to describe the availability of facility resources and services and to analyse their association with maternal outcomes. Methods GLOSS was a facility-based, prospective, 1-week inception cohort study implemented in 713 health-care facilities in 52 countries and included 2850 hospitalised pregnant or recently pregnant women with suspected or confirmed infections. All women admitted for or in hospital with suspected or confirmed infections during pregnancy, childbirth, post partum, or post abortion at any of the participating facilities between Nov 28 and Dec 4 were eligible for inclusion. In this study, we included all GLOSS participating facilities that collected facility-level data (446 of 713 facilities). We used data obtained from individual forms completed for each enrolled woman and their newborn babies by trained researchers who checked the medical records and from facility forms completed by hospital administrators for each participating facility. We described facilities according to country income level, compliance with providing core clinical interventions and services according to women's needs and reported availability, and severity of infection-related maternal outcomes. We used a logistic multilevel mixed model for assessing the association between facility characteristics and infection-related maternal outcomes. Findings We included 446 facilities from 46 countries that enrolled 2560 women. We found a high availability of most services and resources needed for obstetric care and infection prevention. We found increased odds for severe maternal outcomes among women enrolled during the post-partum or post-abortion period from facilities located in low-income countries (adjusted odds ratio 1middot84 [95% CI 1middot05-3middot22]) and among women enrolled during pregnancy or childbirth from non-urban facilities (adjusted odds ratio 2middot44 [1middot02-5middot85]). Despite compliance being high overall, it was low with regards to measuring respiratory rate (85 [24%] of 355 facilities) and measuring pulse oximetry (184 [57%] of 325 facilities). Interpretation While health-care facilities caring for pregnant and recently pregnant women with suspected or confirmed infections have access to a wide range of resources and interventions, worse maternal outcomes are seen among recently pregnant women located in low-income countries than among those in higher-income countries; this trend is similar for pregnant women. Compliance with cost-effective clinical practices and timely care of women with particular individual characteristics can potentially improve infection-related maternal outcomes. Funding UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, WHO, Merck for Mothers, and US Agency for International Development. Copyright (c) 2021 World Health Organization; licensee Elsevier. This is an Open Access article under the CC BY 3.0 IGO license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any use of this article, there should be no suggestion that WHO endorses any specific organisation, products, or services. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.

Details

Language :
English
ISSN :
2214109X
Database :
OpenAIRE
Journal :
LANCET GLOBAL HEALTH, lancet global health, 9(9), e1252-e1261. Elsevier BV, The Lancet. Global Health
Accession number :
edsair.doi.dedup.....297453625a5344bd5cccfe8844cae764