July 4, 2020
On maternal health challenges

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From the article: "By publicizing the horrifying research results alongside heartbreaking stories of black women’s maternal encounters, advocates have helped to garner national attention. In April 2019, Senator Kamala Harris and Congresswoman Alma Adams led efforts to officially declare April 11-17 as “Black Maternal Health Week” with a resolution brought before the US Congress.[7] Rapidly, #blackmaternalhealthweek became a treading hashtag on Twitter and Instagram transforming social media into virtual safe spaces for black women across the nation to share their child birthing experiences. Black women’s stories of maternal death, childbirth trauma, postpartum, and encounters with negligent behavior by medical staff have claimed cover pages of major newspapers and magazines. Most famously perhaps are The New York Times and Vogue articles featuring Serena Williams’ near-death experiences following her daughter’s birth.[8],[9] This year, some women’s magazines, including Womanly Magazine and Self, published special issues on black maternal health. The Spring 2019 issue of Womanly Magazine incorporated a collection of scholarly articles, essays, poetry,[10] and even a guide outlining how to advocate for one’s self during pregnancy and childbirth.[11]"

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From the article: "MomConnect is a national initiative coordinated by the South African National Department of Health that sends text-based mobile phone messages free of charge to pregnant women who voluntarily register at any public healthcare facility in South Africa. We describe the system design and architecture of the MomConnect technical platform, planned as a nationally scalable and extensible initiative. It uses a health information exchange that can connect any standards-compliant electronic front-end application to any standards-compliant electronic back-end database. The implementation of the MomConnect technical platform, in turn, is a national reference application for electronic interoperability in line with the South African National Health Normative Standards Framework. The use of open content and messaging standards enables the architecture to include any application adhering to the selected standards. Its national implementation at scale demonstrates both the use of this technology and a key objective of global health information systems, which is to achieve implementation scale. The system’s limited clinical information, initially, allowed the architecture to focus on the base standards and profiles for interoperability in a resource-constrained environment with limited connectivity and infrastructural capacity. Maintenance of the system requires mobilisation of national resources. Future work aims to use the standard interfaces to include data from additional applications as well as to extend and interface the framework with other public health information systems in South Africa. The development of this platform has also shown the benefits of interoperability at both an organisational and technical level in South Africa."

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From the article: "There is an abundant literature on the relationship between women’s education and maternal and child outcomes, including antenatal and postnatal care, onset of antenatal care and skilled birth attendance. However, few studies have adopted the ‘equity’ lens, despite increasing evidence that inequities between rich and poor are increasing although maternal and child mortality is declining. This study examined the differential effects of women’s education within different socioeconomic strata in Africa. The most recent Demographic and Health Surveys (DHS) conducted in the Democratic Republic of the Congo, Egypt, Ghana, Nigeria and Zimbabwe were used. In each country, the original sample was stratified into three socioeconomic groups: poor, middle and rich. For each maternal health service utilization variable, the gross and net effects of women’s education, controlling for age, parity, religion, marital status, health insurance, access to health facilities, partner’s education and current place of residence, were estimated using logistic regression, taking into account the complex sampling design of the DHS. The findings revealed country-specific variations in maternal health service utilization, and for most indicators there was a clear gradient among socioeconomic strata: women living in better-off households exhibited greater access to, and utilization of, maternal health services. "