Magister Curationis - MCur / The present study examined the extent of utilization of partogram among nurses and midwives in Rwamagana health facilities located in the eastern province of Rwanda. The study specifically sought to; assess knowledge and use of partogram among nurses and midwives in Rwamagana health facilities, to identify the challenges facing nurses and midwives with regards to the utilization of partogram in the health facilities and to determine factors influencing the use of partogram among nurses and midwives in Rwamagana health facilities. Patricia Benner’s model of nursing practice was used to guide this study

<p>Over the last century, developed countries have been successful in enhancing maternal health and reducing Maternal Mortality Ratio (MMR). By 2018, MMR across OECD countries and World Bank Group Regions have converged towards very low levels, averaging more than 5 deaths per 100,000 live births. The United States has become an outlier among the developed countries in maternal deaths and compares unfavorably to a number of poorer countries where the ratio has declined. In 2017, the US ranked worst in MMR among the 39 industrialized nations. United States has experienced almost a 142 percent increase in MMR from 1987-2018. According to the Centers for Disease Control and Prevention (CDC), every year in the US, more than 700 women die due to the pregnancy or childbirth-related complications, with 60 percent of these deaths being preventable. Within the US, MMR varies considerably, leaving large disparities across states as well as between all racial groups. This research study aims to understand the interplay of spatial and racial impacts on the variation of maternal mortality ratios within the US. The paper estimates Ordinary Least Squares (OLS) and Spatial Lag Models for MMR using cross-sectional US state data for 2012-2017, taken from CDC. The results show that the dominant root causes of high maternal mortality differ between black and white women. </p> <p> </p>

Dissertation submitted in fulfilment of the requirements for the degree Doctor of Technology: Informatics in the Faculty of Informatics and Design at the Cape Peninsula University of Technology / Background: Daily activities within a health care organization are mediated by information communication processes (ICP), which involve multiple health care professionals. During pregnancy, birth and motherhood a woman may encounter different professionals including midwives, doctors, laboratory personnel and others. Effective management requires critical information to be accurately communicated. If there is a breakdown in this communication patient safety is at risk for various reasons such as; inadequate critical information, misconception of information and uninformed decisions being made. Method: Multi method, multiple case study approach was used to explore and describe the complexities involved in the (ICP), during the management of the intrapartum period. During the study the expected ICP, the actual ICP, the challenges involved and the desired ICP were analysed. 24 In-depth interviews with skilled birth attendants were conducted, observer- as- participant role was utilized during the observation, fild notes, reflective diaries and document review methods were used to gather the data. Thematic analysis and activity analysis were applied to analyse the data. Findings: The findings illuminated that there are expectations of accessibility to care of the woman during pregnancy birth and the intrapartum, especially linked to referral processes. The actual ICP focused on documentation and communication of the information within and between organizations. Communication was marked by inadequate documentation and therefore errors in the information communicated. The desires for communication were illuminated by the need to change the current situation. Further a framework for effective information communication was developed: the FAAS framework for the effective management of the intrapartum period. Conclusion: In conclusion what is expected is not what is actually happening. The skilled birth attendants (SBAs) do not necessarily have the answers for change but the challenges were identified as desires for change. I urge that the framework will provide a basis for the evaluation of the effectiveness involved in the ICP for the effective management of the intrapartum period.

Abortion and severe pre-eclampsia/eclampsia remain the major causes of maternal mortality in Zimbabwe. Based on this problem, factors associated with maternal mortality due to abortion and severe pre-eclampsia/eclampsia were investigated to improve pregnancy outcomes. Cases and controls were selected from 4895 abortion and 318 severe preeclampsia/ eclampsia obstetric records to conduct a retrospective case-control study. Significant risk factors identified for reducing maternal mortality due to postabortion complications included the administration of oxytocic drugs and evacuations of the uterus whilst anaemia and sepsis apparently reduced these women's chances of survival. No significant factors could be identified which influenced maternal deaths among women suffering from severe pre-eclampsia/eclampsia. Magnesium sulphate was not routinely administered, as recommended internationally. In both groups, cases apparently received better reported quantitative care than controls. Recommendations based on this research report include improved midwifery education and in-service training, regular audits of patients' records and changed policies for managing these conditions more effectively in Zimbabwe. / Health Studies / D. Litt. et Phil. (Advanced Nursing Sciences)

Abortion and severe pre-eclampsia/eclampsia remain the major causes of maternal mortality in Zimbabwe. Based on this problem, factors associated with maternal mortality due to abortion and severe pre-eclampsia/eclampsia were investigated to improve pregnancy outcomes. Cases and controls were selected from 4895 abortion and 318 severe preeclampsia/ eclampsia obstetric records to conduct a retrospective case-control study. Significant risk factors identified for reducing maternal mortality due to postabortion complications included the administration of oxytocic drugs and evacuations of the uterus whilst anaemia and sepsis apparently reduced these women's chances of survival. No significant factors could be identified which influenced maternal deaths among women suffering from severe pre-eclampsia/eclampsia. Magnesium sulphate was not routinely administered, as recommended internationally. In both groups, cases apparently received better reported quantitative care than controls. Recommendations based on this research report include improved midwifery education and in-service training, regular audits of patients' records and changed policies for managing these conditions more effectively in Zimbabwe. / Health Studies / D. Litt. et Phil. (Advanced Nursing Sciences)