Author
Buyanjargal Yadamsuren
Bio: Buyanjargal Yadamsuren is an academic researcher. The author has contributed to research in topics: Standardized mortality ratio & Health facility. The author has an hindex of 4, co-authored 4 publications receiving 645 citations.
Papers
More filters
••
UNICEF1, Khon Kaen University2, University of Nairobi3, University of Ibadan4, Makerere University5, Abdou Moumouni University6, Peking University7, Pakistan Institute of Medical Sciences8, Government of Nepal9, Indian Council of Medical Research10, Pokhara University11, Chulalongkorn University12, University of Tokyo13, American University of Beirut14, State University of Campinas15, Institute for Health Metrics and Evaluation16, Inter-American Development Bank17, National Autonomous University of Nicaragua18, Dalhousie University19, University of Adelaide20, Emory University21, Uppsala University22, All India Institute of Medical Sciences23, University of Pretoria24, United States Agency for International Development25
TL;DR: High coverage of essential interventions did not imply reduced maternal mortality in the health-care facilities the authors studied, and the maternal severity index (MSI) had good accuracy for maternal death prediction in women with markers of organ dysfunction.
533 citations
••
TL;DR: In this article, the authors report the main findings of the WHO Multicountry Survey on Maternal and Newborn Health (WHOMCS), which aimed to assess the burden of complications related to pregnancy, the coverage of key maternal health interventions, and use of the maternal severity index (MSI) in a global network of health facilities.
Abstract: Summary Background We report the main findings of the WHO Multicountry Survey on Maternal and Newborn Health (WHOMCS), which aimed to assess the burden of complications related to pregnancy, the coverage of key maternal health interventions, and use of the maternal severity index (MSI) in a global network of health facilities. Methods In our cross-sectional study, we included women attending health facilities in Africa, Asia, Latin America, and the Middle East that dealt with at least 1000 childbirths per year and had the capacity to provide caesarean section. We obtained data from analysis of hospital records for all women giving birth and all women who had a severe maternal outcome (SMO; ie, maternal death or maternal near miss). We regarded coverage of key maternal health interventions as the proportion of the target population who received an indicated intervention (eg, the proportion of women with eclampsia who received magnesium sulphate). We used areas under the receiver operator characteristic curves (AUROC) with 95% CI to externally validate a previously reported MSI as an indicator of severity. We assessed the overall performance of care (ie, the ability to produce a positive effect on health outcomes) through standardised mortality ratios. Results From May 1, 2010, to Dec 31, 2011, we included 314 623 women attending 357 health facilities in 29 countries (2538 had a maternal near miss and 486 maternal deaths occurred). The mean period of data collection in each health facility was 89 days (SD 21). 23 015 (7·3%) women had potentially life-threatening disorders and 3024 (1·0%) developed an SMO. 808 (26·7%) women with an SMO had post-partum haemorrhage and 784 (25·9%) had pre-eclampsia or eclampsia. Cardiovascular, respiratory, and coagulation dysfunctions were the most frequent organ dysfunctions in women who had an SMO. Reported mortality in countries with a high or very high maternal mortality ratio was two-to-three-times higher than that expected for the assessed severity despite a high coverage of essential interventions. The MSI had good accuracy for maternal death prediction in women with markers of organ dysfunction (AUROC 0·826 [95% CI 0·802–0·851]). Interpretation High coverage of essential interventions did not imply reduced maternal mortality in the health-care facilities we studied. If substantial reductions in maternal mortality are to be achieved, universal coverage of life-saving interventions need to be matched with comprehensive emergency care and overall improvements in the quality of maternal health care. The MSI could be used to assess the performance of health facilities providing care to women with complications related to pregnancy. Funding UNDP–UNFPA–UNICEF–WHO–World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP); WHO; USAID; Ministry of Health, Labour and Welfare of Japan; Gynuity Health Projects.
113 citations
••
Mercedes Bonet, Vanessa Brizuela, Edgardo Abalos, Cristina Beatriz Cuesta +163 more•Institutions (1)
TL;DR: The results suggest that contribution of direct and indirect infections to overall maternal deaths is greater than previously thought and improvement of early identification is urgently needed, as well as prompt management of women with infections in health facilities by implementing effective evidence-based practices.
65 citations
••
TL;DR: To evaluate the extent to which stillbirths affect international comparisons of preterm birth rates in low‐ and middle‐income countries, a large number of countries are considered to be at risk of low birth rates.
26 citations
Cited by
More filters
••
TL;DR: Between 2003 and 2009, haemorrhage, hypertensive disorders, and sepsis were responsible for more than half of maternal deaths worldwide, and more than a quarter of deaths were attributable to indirect causes.
3,976 citations
••
TL;DR: To better understand the epidemiology of preterm birth, the quality and volume of data needs to be improved, including standardisation of definitions, measurement, and reporting.
1,579 citations
••
Harvard University1, New York University2, World Bank3, Mexican Social Security Institute4, Wellcome Trust5, Inter-American Development Bank6, University of Ibadan7, Northwestern University8, Bill & Melinda Gates Foundation9, Malawi University of Science and Technology10, University of London11, Duke University12, University of Bergen13, Public Health Foundation of India14, Centers for Disease Control and Prevention15, Stanford University16, Kathmandu17
TL;DR: High-quality health systems in the Sustainable Development Goals era: time for a revolution.
1,434 citations
••
TL;DR: Based on MMR estimates for 2015, scenario-based projections are constructed to highlight the accelerations needed to accomplish the Sustainable Development Goal (SDG) global target of less than 70 maternal deaths per 100,000 live births globally by 2030.
1,284 citations
••
TL;DR: A system-level shift from maternal and newborn care focused on identification and treatment of pathology for the minority to skilled care for all is supported, which includes preventive and supportive care that works to strengthen women's capabilities in the context of respectful relationships.
936 citations