Chauke Lawrence
Faculty of Health Sciences, Department of Obstetrics and Gynaecology, University of the Witwatersrand, Johannesburg, South Africa; Department of Obstetrics and Gynaecology, Charlote Maxeke Johannesburg Academic Hospital, Gauteng Department of Health, Johannesburg, South Africa.
Best Pract Res Clin Obstet Gynaecol. 2025 Feb;98:102572. doi: 10.1016/j.bpobgyn.2024.102572. Epub 2024 Dec 6.
While maternal deaths have declined by a third between 2000 and 2020, approximately 800 women continue to die every day due to pregnancy-related complications. For every woman who dies, many more experience life-debilitating conditions. Most of these deaths occur in low- and middle-income countries (LMICs). Women in Sub-Saharan Africa (SSA) face the highest risk of mortality, with a lifetime risk of dying from pregnancy-related complications estimated at 1 in 40. Given the unpredictable nature of pregnancy complications, emergency obstetric care (EmOC) remains the most effective strategy to reduce the global burden of maternal deaths due to pregnancy related complications. Investing in EmOC can assist countries struggling with high burden of maternal mortality in staying on track toward achieving the United Nations' 2030 Sustainable Development Goals (SDGs). However, LMICs encounter several challenges in accessing these life-saving interventions. This article utilises Thaddeus and Maine's three-delay model to analyse barriers to EmOC in LMICs and to propose potential solutions.
虽然2000年至2020年间孕产妇死亡人数下降了三分之一,但每天仍有大约800名妇女因与妊娠相关的并发症而死亡。每有一名妇女死亡,就有更多的妇女经历影响生活的疾病。这些死亡大多发生在低收入和中等收入国家(LMICs)。撒哈拉以南非洲(SSA)的妇女面临的死亡风险最高,因妊娠相关并发症死亡的终身风险估计为四十分之一。鉴于妊娠并发症的不可预测性,紧急产科护理(EmOC)仍然是减轻全球因妊娠相关并发症导致的孕产妇死亡负担的最有效策略。投资于紧急产科护理可以帮助那些孕产妇死亡率高的国家在实现联合国2030年可持续发展目标(SDGs)的道路上保持正轨。然而,低收入和中等收入国家在获得这些救命干预措施方面面临若干挑战。本文利用萨德厄斯和缅因州的三延迟模型来分析低收入和中等收入国家紧急产科护理的障碍,并提出潜在的解决方案。