Achieving the Millennium Development Goal of reducing maternal mortality in rural Africa: an experience from Burundi
Achieving the Millennium Development Goal of reducing maternal mortality in rural Africa: an experience from Burundi
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DOI：
10.1111/tmi.12022
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发表时间：
2013-02-01
影响因子：
3.3
通讯作者：
Harries, A. D.
中科院分区：
文献类型：
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作者：
Tayler-Smith, K.;Zachariah, R.;Harries, A. D.
目的评估无国界医生(MSF)提供的紧急产科护理降低的孕产妇死亡率，并将其与降低孕产妇死亡率的第五个千年发展目标进行比较。方法通过估计无国界医生组织在布隆迪卡贝齐的紧急产科护理机构转移和治疗的妇女的死亡人数来估计无国界医生组织干预的影响，这些妇女有严重的急性孕产妇发病率。利用这一估计数，计算了卡贝齐的产妇死亡率，并与布隆迪的千年发展目标进行了比较。结果2011年，1385名来自Kabezi的妇女被转移到MSF设施，其中55%患有严重的急性孕产妇发病率。我们估计，无国界医生组织的干预措施避免了Kabezi区74%(范围55-99%)的孕产妇死亡，相当于该地区的孕产妇死亡率为208(8360)例死亡/100，相当于1000例活产。这非常接近布隆迪2015年千年发展目标5的目标(285例死亡/100例活产)。结论提供高质量的产科急救服务，并结合有效的病人转送系统，可迅速大幅降低产妇死亡率，因此可能是在非洲农村实现千年发展目标5的可能途径。
Objectives To estimate the reduction in maternal mortality associated with the emergency obstetric care provided by Medecins Sans Frontieres (MSF) and to compare this to the fifth Millennium Development Goal of reducing maternal mortality. Methods The impact of MSF's intervention was approximated by estimating how many deaths were averted among women transferred to and treated at MSF's emergency obstetric care facility in Kabezi, Burundi, with a severe acute maternal morbidity. Using this estimate, the resulting theoretical maternal mortality ratio in Kabezi was calculated and compared to the Millennium Development Goal for Burundi. Results In 2011, 1385 women from Kabezi were transferred to the MSF facility, of whom 55% had a severe acute maternal morbidity. We estimated that the MSF intervention averted 74% (range 55-99%) of maternal deaths in Kabezi district, equating to a district maternal mortality rate of 208 (range 8360) deaths/100 similar to 000 live births. This lies very near to the 2015 MDG 5 target for Burundi (285 deaths/100 similar to 000 live births). Conclusion Provision of quality emergency obstetric care combined with a functional patient transfer system can be associated with a rapid and substantial reduction in maternal mortality, and may thus be a possible way to achieve Millennium Development Goal 5 in rural Africa.