Masaba Brian Barasa, Mmusi-Phetoe Rose
Department of Health Studies, University of South Africa (UNISA), College of Human Sciences, School of Social Sciences, Pretoria, South Africa.
Int J Womens Health. 2023 Apr 3;15:487-498. doi: 10.2147/IJWH.S396257. eCollection 2023.
Migori County is categorized among regions with worst maternal survival rates in Kenya. The county's current maternal mortality ratio (MMR) is 673 deaths per 100 000 live births. A need exists for a context-specific strategy to mitigate the persistent high maternal mortalities in rural Kenya. The researchers aimed to develop a strategy for reducing the maternal mortality ratio (MMR) in Migori, Kenya.
An explanatory sequential mixed methods design was utilised. The design was characterised by two separate studies, an initial quantitative followed by a qualitative study. The final phase entailed integration of data from the two separate studies. The findings, extensive literature review and three delays of maternal mortality theoretical framework informed the development of the strategy.
The strategy for implementation considered three strategic areas, namely, interventions targeting first delays, interventions targeting second delays, interventions targeting third delays.
The priority interventions needed are those that enable: 1) Pregnant mothers to receive quality peripartum care in Migori hospitals, 2) Strengthened and efficient referral systems of obstetric emergencies and 3) Community knowledge empowerment on safe pregnancy and culture shift. These interventions would significantly transform the health-care system towards maternal mortality reduction. The Kenyan government and non-profit organisations should be involved in the implementation of the proposed strategy.
米戈里县在肯尼亚是孕产妇存活率最低的地区之一。该县目前的孕产妇死亡率为每10万例活产中有673例死亡。需要制定一项针对具体情况的战略，以缓解肯尼亚农村地区持续居高不下的孕产妇死亡率。研究人员旨在制定一项降低肯尼亚米戈里县孕产妇死亡率（MMR）的战略。
采用了解释性顺序混合方法设计。该设计的特点是有两项独立研究，首先是定量研究，然后是定性研究。最后阶段需要整合两项独立研究的数据。研究结果、广泛的文献综述以及孕产妇死亡的三个延误理论框架为该战略的制定提供了依据。
实施该战略考虑了三个战略领域，即针对首次延误的干预措施、针对第二次延误的干预措施、针对第三次延误的干预措施。
所需的优先干预措施应能实现以下几点：1）使怀孕母亲在米戈里县的医院获得高质量的围产期护理；2）加强并高效运行产科急诊转诊系统；3）增强社区对安全怀孕的认识并实现文化转变。这些干预措施将显著改变医疗保健系统，以降低孕产妇死亡率。肯尼亚政府和非营利组织应参与拟议战略的实施。
