Sepsis education for stakeholders in Sub-Saharan Africa

pedclerk.bsd.uchicago.edu

Sepsis is also known as blood poisoning, and can be triggered by an infection in any part of the body (e.g. urinary tract). 

For a detailed definition in relation to pregnancy, it is an:

“Infection of the genital tract occurring at anytime between the rupture of membrane or labour, and the 42^nd day postpartum, of which two or more of the following are present: pelvic pain, fever 38.5^oC or more, abnormal vaginal discharge, abnormal smell of discharge, and delay in the rate of reduction of size of uterus (less than 2cm a day during the first 8 days)”(Bamfo, 2013)

Research strongly suggests that there is a link between unhygienic circumstances and sepsis. For example women may encounter such situations when they use untrained traditional birth attendants for deliveries. Reports show that majority of women in Sub-Saharan Africa deliver outside health facilities, without skilled attendants (e.g. 69% of Nigerian women).

Majority of sepsis-induced deaths are almost entirely preventable with the effective usage of aseptic techniques, and the timely detection and treatment of infections. On one end of the spectrum, the women of childbearing age should be encouraged to seek out adequate health care institutions during pregnancy.

While on the other end, the women’s health care seeking behaviors were not solely to be blamed for the acute sepsis influenced deaths. The health-care institutions are also responsible, due to lack of preparedness and neglect. It has been reported that in low-income countries such as Nigeria, clean birth practices, in parallel with monitoring and active third stage management, may potentially prevent up to 23% of maternal death. Indicating the need for communicating the importance of quality checks and controls, with regards to service providers and their facilities.

The reduction of sepsis-induced deaths was an essential instrument for the reduction of maternal mortality rates in developed countries such as the United Kingdom. With such revelation, isn’t it time this direct cause of maternal mortality is paid more attention?

The potential negative health influence of native/home births and utilisation of unskilled traditional birth attendants has been indicated, and this will be discussed in the next post. 

   

As always please feel free to leave your comments.

Reality of maternal health in Nigeria (Part 2)

 

      

Part 1 (see here) suggested that changing behavioural patterns of the women has the potential to save them. Most of the maternal deaths occurring are partially preventable by reducing behavioural risk factors such as poor utilisation of health services, and lack of skilled birth attendant during delivery.

In developed countries, research on the relationship between education and health has highlighted the concept of health literacy. The World Health Organization (WHO) has defined health literacy as “the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand, and use information in ways that promote and maintain good health.” Basically, it is the degree to which the women of childbearing age have the capacity to get, process and understand essential health information and services needed. Poor health literacy can affect the recognition and understanding of the health problems that can occur during pregnancy. Thereby reducing the chances of the women in surviving any future adverse outcome.

These women can be said to judge risk based on their feelings and emotions, implying that social factors and their cognitive biases can distort risk perception and hinder any risk communication. The issues that arise here are those dealing with how to overcome these biases and factors that impede the women from making proper health care decisions.

The success and failure in reducing maternal mortality lie with the intervention of the government, their willingness to implement policies, public acceptance of the interventions, and willingness to achieve individual change. Every woman has a mental model for making sense of situations and processing of information. These mental models are fragmentary beliefs and perceptions that have been formed over time by interactions and society. So it is only wise for health care professionals and communicators to understand the underlying reasons why the women make certain dangerous health care decisions. This will potentially enhance the effectiveness of any health literacy interventions for the encouragement of proper pregnancy and delivery routes.

There is, therefore, a credible explanation, to demand that communication and advocacy include all the necessary stakeholders of the risk, from the lay people to the experts/policy makers.

As always please feel free to drop your comments.

'DRY' The movie and Vesicovaginal fistula (VVF)

Hello everyone,

With over 2 million women living with obstetric fistula in Asia and Sub-Saharan Africa, I just wanted bring your attention to this epic, emotional, and compelling movie called ‘DRY’. It aptly summarises the fact that we have to take action now. It tells a story of a young doctor, and her dark past as a victim of rape, obstetric fistula, and abandonment. All these were unfortunate circumstances that she did not ask for as a child born into the world innocent.

Turning away from the lead character, the movie goes on to show other women in the village struggling with Vesicovaginal fistula (VVF). The encouraging part in the film was that some sufferers were reporting to the hospitals for repairs and treatments. However, they faced barriers, which included low staffing levels, poorly incentivized workers, and lack of supplies.

Not to give you plenty spoilers from the movie, but several issues and how they tackled the problems, struck a chord.

Issues

• Children giving birth to babies.
• Women interestingly attending antenatal classes, but eventually being forced to give birth at home at the onset of labour.
• The lay villagers don’t know any better than to continue their archaic dangerous practices.
• Practice of under-age marriage.
• Lack of facilities and supplies.
• Lack of education and communication.
• Folk beliefs and ignorance.

Solutions

• Mobile clinics to serve hard to reach women in deeply rural areas.
• Political will, funding and making the lives of women a major priority.
• International interests and assistance.

A big kudos goes to the director of the movie (Mrs Stephanie Linus). By bringing these issues and solutions to the general public knowledge, it encourages the demystification of the problem of VVF as being a sort of punishment,  a helpless situation, or a consequence of witchcraft. Also, it has brought to the forefront the plight of the underserved young populace in the mostly rural regions of Nigeria.

Reality of maternal health in Nigeria (Part 1)

Nigeria is known to be the most populous country in Africa with a population of about 173 million people. Unfortunately, the country has one of the world’s worst indices for maternal mortality rate, with an estimated lifetime risk of maternal death being 1 in 31 compared to that of high resource countries (1 in 3700). Plainly speaking, there is a major public heath issue concerning the welfare of mothers in the country fondly called the Giant of Africa. 

These statistics are truly alarming and unfortunate as it has been recognised that so many of these deaths are preventable and should not be occurring in this modern age. However, explanations to these figures began to emerge as it was revealed that approximately two-thirds of all the Nigerian women and three-quarters of rural women deliver their babies outside health facilities, and without skilled birth attendants. 

This revelation may suggest that changing behavioural patterns of the women has the potential to save women. But how do we influence a shift from the norm? 

P.S: This blog encourages a more participatory approach to the discussions of the issues raised. Please feel free to leave your suggestions and comments. 

New beginnings !!!

Hello Everyone

Welcome to my world. As a final year Phd Public Health Candidate, I am now using this platform to make a much needed transition, bringing the findings from my research to the general public. In addition to discussing general burgeoning issues plaguing the public health field (e.g Maternal mortality) especially in Africa.

I have been fortunate and lucky to have the ability to pursue a quality education. This has been the primary driver to my dreams and aspirations, giving me the tools to break barriers and inspire younger people in my sphere of contact. This is my story, but what about the individuals without such opportunities. Sadly no-one possesses a magic formula that can perfect the world. However, every little effort counts.

Welcome once again to this blog, each post will be short and concise I hope you enjoy the journey.