Thesis (Ph. D.)--University of Washington, 2003. / Vita. Includes bibliographical references (leaves 127-134).

Children’s health outcomes are affected by multiple variables, including biological, environmental, psychological and social factors. Many determinants are decided after birth depending on the surrounding physical, psychological and social environment that the child enters. Elements such as socioeconomic status, marital status, race, education level and access to healthcare greatly affect a mother’s health literacy, and, thus, her ability to adequately care for her child(ren). This project examines the impact of maternal health literacy training on the knowledge of mothers, who have been homeless. Ninety-one women completed a six-hour maternal health literacy training. A pre-posttest design was used to measure maternal knowledge change as the result of the training. The same measure was used at both time points, and the measure was designed in a multiple-choice format. Outcomes indicate that the maternal health literacy training positively impacted reported maternal child health knowledge. Additionally, a follow-up survey was given to 11% of the total sample, to examine the sustainability of the knowledge gains 2-4 months post-training. Findings indicate that the women who took the follow-up survey retained a considerable amount of health literacy knowledge. This is a first step into research examining how maternal health literacy training improves short and long term knowledge in a high risk sample of mothers. The positive outcomes suggest that this program could be beneficial to agencies across the country serving maternal needs in similar circumstances. Recommendations for further research are discussed.

The hospitalization of childbirth and maternal care in Sweden is from an international perspective quite unique. It was implemented already in the beginning of the 20th century and fully mainstreamed by the 1960’s. This essay examines the professional discussions of midwives and doctors as depicted in their union’s membership papers, during the hospitalization period. The hospitalization of childbirths presented a shift in responsibility and power from the midwives to the doctors, which has lead previous research to analyse this development as a clear conflict of professional interest. I will argue however that the professional frictions came later, as the midwife profession grew stronger as a collective, and were not so much present in the actual making. This essay investigates why, and touches upon class and gender divergences as explanatory factors. My findings are in part that the overtaking was more elaborate from the doctor’s point of view than the midwives. Through undermining the midwives professional competence, denying them necessary resources and advocating their superiority in the midwives internal debates, the doctor’s managed to steer the development of hospitalization and establish the hierarchy that followed. Today’s lively and sometimes infectious debate on the organization of childbirth and maternal care highlights the necessity for a deeper historical understanding and background to the indeed different positions midwives and doctors take in this regard.

Thesis (Ph. D.)--University of Technology, Sydney, 2005. / Includes bibliographical references (p. 301-316).

Thesis (M. Mid.)--University of Sheffield, 2007. / "June, 2007." Issued as part of the Canadian electronic library documents collection. Includes bibliographical references (p. 45-55).

Thesis (Ph.D.) - University of Queensland, 2005. / Includes bibliography.

Thesis (M.A.)--Indiana University, 2006. / Title from screen (viewed on Apr. 30, 2007) Department of History, Indiana University-Purdue University Indianapolis (IUPUI) Includes vita. Includes bibliographical references (leaves 100-108)

Magister Curationis / Research has shown that there is a problem in the delivery of quality care in maternal and child health services in Zambia. The 1996 Zambia demographic and health survey estimated maternal mortality rate as high as 649 per 100,000 live birth, with this reason among others, human resource constraints and low number of supervised antenatal clinics, deliveries and postnatal clinics by skilled personnel as some of the reasons for the high maternal mortality. Selected studies identify the role of a clinical nurse specialist in advanced midwifery and neonatology who has acquired the knowledge and practical skills to bring about the desired impact of quality care in safe mother hood in order to bring down the high maternal mortality rates. In order to achieve this, the government needs to integrate the advanced midwifery and neonatology clinical nurse specialist in the health system. It was the purpose of the study to inquire into the feasibility of integration of the advanced midwifery and neonatology clinical nurse specialist in the Ndola District Health system . / South Africa

Master of Public Health - MPH / Maternal health care services are one of the health interventions to reduce maternal and infant morbidity and mortality. The health of mothers of childbearing age and of the unborn babies is influenced by many factors some of which include the availability and accessibility of health services for pregnant women. Low quality of health services being provided, and limited access to health facilities is correlated with increases maternal morbidity and mortality. This situation is caused by long distances between facilities as well as the people's own beliefs in traditional practices. This study was about the assessment of the women's knowledge on benefits of delivery in a hospital, the barriers to delivery services, and the perception of the delivery services rendered in the maternity ward of Okakarara hospital. / South Africa

Magister Public Health - MPH / Background: Maternal mortality is a significant public health problem world-wide,as it is an important indicator for the functioning of the health system. The maternal mortality ratio for Botswana is higher than other countries with comparable economic growth, despite impressive access to health services. In order to develop relevant programs and policies to reduce maternal mortality, the factors associated with maternal mortality were studied. The study aimed to describe the maternal and health services factors associated with maternal mortality in South East Botswana. Methodology: A quantitative case-control study was used to retrospectively review medical records for 71 cases of maternal deaths and 284 controls randomly selected from mothers who delivered in the same year and at the same health facility, in South East Botswana from 2007 to 2009. Information was collected on the maternal and health services characteristics of the cases and controls including age, level of education, marital status, parity, utilization of health facilities that consist of antenatal care (ANC), type of delivery, complications during pregnancy, type of health facility and ANC provider. Data was analyzed using Predictive Analysis Software (PASW) Version 18.Two-sample t- test, Pearson’s Chi-square test and the Fisher’s exact test were used to test the difference between the proportions of the various categories of variables in cases and controls. Univariate logistic regression analysis was applied to identify the risk factors associated with maternal deaths. A multivariate logistic regression model was estimated to see the joint effects of the identified risk factors for maternal mortality. Hosmer and Lemeshow test was used to test the goodness of fit of the model. Results: The mean age of the maternal deaths was 28.0 ± 5.3 years and they had taken place at a hospital (100%). A large number of deaths occurred before delivery(59.0%). The causes of maternal death included both direct (73%) and indirect causes (27%). Direct causes were the leading causes of death and they were abortion(22.5%) and haemorrhage (18.3%). The maternal characteristics associated with maternal mortality were having complications at delivery (OR=20.91), not receiving ANC (OR=6.31) and delivering by caesarean section (OR= 2.66). The health facility characteristics associated with maternal mortality were delivering outside the health facility (OR=14.78), having been referred from another facility (OR=8.62) and delivering at a general hospital (OR=5.91). The data produced a model with good fit that included one maternal risk factor and three health facility risk factors. These were being admitted with preterm labour, delivering at a general hospital or before arrival at the health facility and having been referred from another health facility. Conclusion: Maternal mortality was associated with both maternal and health facility risk factors. The model developed may be used to identify and manage highrisk women to reduce the number of maternal deaths. It was recommended that, the current system should continue to be monitored and evaluated through the Maternal Mortality Monitoring System (MMMS). Furthermore, the referral and management of complications needs to be strengthened through a multi-sectoral approach.