Poor maternal and neonatal outcomes in low and middle imcome countries: epidemiological analyses of contributing factors

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Abstract

[Truncated] Significant progress has been made in recent decades in reducing maternal and newborn deaths and stillbirths and improving access to facility services for childbirth in low-­and middle-­income countries. However, the risk of mortality and morbidity for pregnant women and newborns in many countries worldwide remains unacceptably high. A lack of reliable maternal and perinatal morbidity and mortality data is a significant limitation to understanding factors that contribute to poor outcomes in these settings.
The primary aim of this dissertation was to better understand factors contributing to poor maternal and neonatal outcomes in low-­ and middle-income countries. Three WHO multi-­country datasets from recent studies of women and newborns in predominantly low-­ and middle-­income countries were used, namely:
• The WHO Antenatal Care Trial (1996 – 1998), a cluster-­randomized controlled trial of 24,526 women attending antenatal care in four countries that evaluated the effectiveness, acceptability and cost of an antenatal care package of goal-oriented, reduced visits for low-­risk women;
• The WHO Global Survey on Maternal and Perinatal Health (2004 – 2008), a facility-­based, cross-­sectional survey of 290,610 women delivering in facilities in 24 countries; and
• The WHO Multi-­Country Survey on Maternal and Newborn Health (2010 – 2011), a facility-­based cross-­sectional survey of 314,623 women delivering in facilities in 29 countries.
From these three datasets, four thematic areas and nine epidemiological research questions were identified.
Original languageEnglish
QualificationDoctor of Philosophy
StateUnpublished - 5 Dec 2014


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