Erhardt-Ohren Blake, Paul Dipika, Mahmud Anik, Tarannum Anika, Weidert Karen, Hossain Altaf, Rubayet Sayed, Prata Ndola
Bixby Center for Population, Health, & Sustainability, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America.
Ipas Bangladesh, Dhaka, Bangladesh.
PLoS One. 2025 Feb 28;20(2):e0315182. doi: 10.1371/journal.pone.0315182. eCollection 2025.
There is a paucity of research exploring abortion complication-related morbidity and mortality in humanitarian settings. The most recent data we have to understand the impact of global negligence on forcibly displaced persons' reproductive health needs in humanitarian emergencies is from the 1999 United Nations Population Fund's annual report, which estimated that 25-50% of maternal deaths in refugee settings were due to complications from unsafe abortion. This study will investigate maternal death surveillance and reporting (MDSR). The protocol will be implemented in a refugee setting: Forcibly Displaced Myanmar National (FDMN) camps in Cox's Bazar, Bangladesh. We will review death records for the past twelve months to learn more about how deaths are reported and recorded in facilities and in the camp-in-charge (CiC) office. Following the record review, we will interview individuals who provide reproductive healthcare services to FDMN and participate in MDSR where FDMN reside. These interviews will provide context and depth to the maternal death record review. We will implement a novel community-facility capture-recapture (CFCR) methodology to estimate maternal mortality. This research will fill a gap in knowledge about menstrual regulation, safe abortion and post-abortion access and care, and the measurement of maternal death due to abortion-related complications. This study will provide insights into a new opportunity to potentially more accurately measure maternal mortality due to abortion complications in these settings. The evidence gathered in the course of this research may assist global health practitioners in targeting interventions to prevent unsafe abortion and increase access to safe services that are tailored to forcibly displaced populations. The University of California, Berkeley Center for Protection of Human Subjects (CPHS # 2016-04-8614) and the National Research Ethics Committee (NREC) of the Bangladesh Medical Research Council (BMRC) (Registration # 578 10 03 2024) approved this study protocol.
在人道主义环境中，探索与堕胎并发症相关的发病率和死亡率的研究匮乏。我们所拥有的、用以了解全球忽视对人道主义紧急情况下被迫流离失所者生殖健康需求影响的最新数据来自1999年联合国人口基金的年度报告，该报告估计，难民环境中25%-50%的孕产妇死亡是由不安全堕胎并发症所致。本研究将调查孕产妇死亡监测与报告（MDSR）。该方案将在一个难民环境中实施：孟加拉国科克斯巴扎尔的缅甸籍被迫流离失所者（FDMN）营地。我们将查阅过去十二个月的死亡记录，以更多地了解在医疗机构和营地负责人（CiC）办公室中死亡是如何报告和记录的。在记录审查之后，我们将采访为FDMN提供生殖健康护理服务并参与FDMN居住地区MDSR的人员。这些访谈将为孕产妇死亡记录审查提供背景信息和深度。我们将采用一种全新的社区-机构捕获-再捕获（CFCR）方法来估计孕产妇死亡率。本研究将填补在月经调节、安全堕胎及堕胎后服务获取与护理，以及与堕胎相关并发症导致的孕产妇死亡测量方面的知识空白。本研究将为在这些环境中潜在更准确地测量堕胎并发症导致的孕产妇死亡率提供新机会的见解。在本研究过程中收集的证据可能有助于全球卫生从业者确定干预措施，以预防不安全堕胎，并增加为被迫流离失所人群量身定制的安全服务的可及性。加利福尼亚大学伯克利分校人类受试者保护中心（CPHS # 2016-04-8614）和孟加拉国医学研究理事会（BMRC）的国家研究伦理委员会（NREC）（注册号578 10 03 2024）批准了本研究方案。
