International Journal of
Nursing and Midwifery

  • Abbreviation: Int. J. Nurs. Midwifery
  • Language: English
  • ISSN: 2141-2456
  • DOI: 10.5897/IJNM
  • Start Year: 2009
  • Published Articles: 180

Full Length Research Paper

A case series of maternal-newborn delivery outcomes in rural Zambia

Julie M. Buser
  • Julie M. Buser
  • Department of Health Behavior and Biological Sciences, School of Nursing, 400 N. Ingalls, Ann Arbor, MI, 48109, University of Michigan, USA.
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Carol J. Boyd
  • Carol J. Boyd
  • Deborah J Oakley Collegiate Professor Emerita, Center for the Study of Drugs, Alcohol, Smoking and Health (DASH Center), Institute for Research on Mothers and Gender, University of Michigan, USA.
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Cheryl A. Moyer
  • Cheryl A. Moyer
  • Global REACH, Departments of Learning Health Sciences and Obstetrics and Gynecology, University of Michigan Medical School, USA.
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Davy Zulu
  • Davy Zulu
  • Ministry of Health, Lundazi, Zambia.
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Alice Ngoma-Hazemba
  • Alice Ngoma-Hazemba
  • Department of Community and Family Medicine, School of Public Health, University of Zambia, Lusaka, Zambia
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Jessy T. Mtenje
  • Jessy T. Mtenje
  • Africare-Zambia, Lusaka, Zambia.
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Andrew D. Jones
  • Andrew D. Jones
  • Center for Human Growth and Development; Global Public Health Faculty Associate, School of Public Health, University of Michigan, USA
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Jody R. Lori
  • Jody R. Lori
  • Department of Health Behavior and Biological Sciences, School of Nursing, 400 N. Ingalls, Ann Arbor, MI, 48109, University of Michigan, USA.
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  •  Received: 28 October 2019
  •  Accepted: 02 April 2020
  •  Published: 30 April 2020

Abstract

In rural Zambia, pregnant mothers are referred from rural primary health facilities designed to provide Basic Emergency Obstetric and Newborn Care (BEmONC) to district hospitals where Comprehensive Emergency Obstetric and Newborn Care (CEmONC) can be provided when needed. Maternity waiting homes (MWH) are residential dwellings where mothers can await delivery and may offer a possible early referral source to CEmONC, ultimately serving as an intervention to improve maternal-newborn delivery outcomes. This case series study aimed to advance an understanding of maternal-newborn delivery outcomes for mothers referred from health facilities with and without MWHs to one district referral hospital. A retrospective medical record review of district-level data was performed to compare maternal-newborn delivery outcomes for cases referred from five BEmONC health facilities with and five without MWHs to a CEmONC district referral hospital. Information about MWH use was not recorded in the delivery register, and is unknown. Among all cases (n = 234) referred to a district hospital from facilities with and without MWHs, referrals were more likely to come from facilities with MWHs. Most were referred from facilities more than 12km from the district referral hospital. There were no statistically significant differences in newborn delivery outcomes for cases referred from MWH and non-MWH facilities. More cases with prolonged labor were referred from facilities associated with a MWH than without a MWH (37.3 vs. 23.9%). Access to a MWH may have brought mothers closer to a facility where prolonged labor was recognized and emergency referral was made for obstetric management. 

Key words: Newborn health, maternal health, pregnancy complications, delivery outcomes, Zambia.