Fawcus S, Mbizvo M, Lindmark G, Nyström L
Department of Obstetrics and Gynaecology, Grooteschuur Hospital, Cape Town, South Africa.
Stud Fam Plann. 1996 Nov-Dec;27(6):319-27.
A community-based investigation of maternal deaths was undertaken in a rural province (Masvingo) and an urban area (Harare) of Zimbabwe in order to assess their preventability. Avoidable factors were identified in 90 percent of the 105 rural deaths and 85 percent of 61 urban deaths. Delay in seeking treatment contributed to 32 percent and 28 percent of rural and urban deaths, respectively. Lack of transportation delayed or prevented access to healthy facilities in the rural area, a major problem in 28 percent of the cases studied. Suboptimal clinic and hospital management was identified in 67 percent and 70 percent of rural and urban deaths, respectively. Lack of appropriately trained personnel contributed to suboptimal care. In both settings, the severity of patients' conditions was frequently unrecognized, leading to delays in treatment and referral, and inadequate treatment. Appropriate community and health-service interventions to reduce maternal mortality are discussed.
在津巴布韦的一个农村省份(马斯温戈)和一个城市地区(哈拉雷)开展了一项基于社区的孕产妇死亡情况调查,以评估其可预防性。在105例农村死亡病例中的90%以及61例城市死亡病例中的85%发现了可避免因素。寻求治疗的延迟分别导致了农村和城市死亡病例的32%和28%。交通不便在农村地区导致延迟或无法前往医疗机构,在所研究病例中有28%的情况这是一个主要问题。分别在67%的农村死亡病例和70%的城市死亡病例中发现诊所和医院管理欠佳。缺乏经过适当培训的人员导致护理欠佳。在这两种情况下,患者病情的严重程度常常未被认识到,导致治疗和转诊延迟以及治疗不足。文中讨论了为降低孕产妇死亡率而采取的适当社区和卫生服务干预措施。