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Egypt National Maternal Mortality Study Results, Lessons Learned, and Future Challenges Dr. Nahed Matta, USAID/EGYPT

Egypt National Maternal Mortality Study Results, Lessons Learned, and Future Challenges Dr. Nahed Matta, USAID/EGYPT. Study Objectives. To:

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Egypt National Maternal Mortality Study Results, Lessons Learned, and Future Challenges Dr. Nahed Matta, USAID/EGYPT

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  1. Egypt National Maternal Mortality Study Results,Lessons Learned, andFuture ChallengesDr. Nahed Matta, USAID/EGYPT NMMS-SOTA-1

  2. Study Objectives To: • estimate maternal mortality ratios for Egypt, the regions, and nine governorates (Aswan, Luxor, Qena, Beni Suef, Fayoum, Assiut, Kafr El-Sheikh, Suez, and New Valley). • determine main medical causes of maternal death. • determine avoidable factors contributing to maternal death. • assess changes in maternal mortality since first national study in 1992-1993. NMMS-SOTA-1

  3. 250 1992/3 217 2000 200 174 150 132 120 93 100 84 89 50 0 Maternal Mortality Ratios, 2000 and 1992-3, Egypt National Lower NMMS-SOTA-1 Upper Frontier

  4. Causes of Maternal Death • Direct (77%) • Postpartum hemorrhage (34%) • Hypertensive disease (22%) • Antepartum hemorrhage (9%) • Sepsis (8%) • Other (C-Section, ruptured uterus, anesthesia) • Indirect (20%) • Cardiovascular (13%) • Anemia (11%) • Infections and Parasitic diseases (4%) • Other (liver disease, diabetes, urinary tract) NMMS-SOTA-1

  5. Avoidable Factors • Multiple Avoidable Factors (80% had 1 avoidable factor and 93% of women seek medical care) • Types • Health provider factors • Ob/Gyn (43%), GP (11%), Daya (8%),Midwife (4%);, • Health facility factors • Lack of blood (16%), Lack of Drugs and supplies (6%), Lack of Anesthesia (4%), Long distance (4%) • Woman and family factors • Recognize danger signs (30%), Delay (13%) • Antenatal care factors • Lack (19%), Poor (15%) • Family planning factors • Ever use (36%/75%), failure (6%/3%), Unwanted (22%/3%) NMMS-SOTA-1

  6. Program Component & Lessons Learned • Develop Essential Obstetric Care (EOC) Protocols • Ownership in development and wide participation • Disseminate and train • Modify and update • Introduce in Medical Schools • Train health providers using competency based Methodology • Physicians, midwives, nurses and dayas • Introduce on the job clinical supervision • Upgrade delivery rooms and maternity wards • Include staff in needs assessments • Utilize existing resources (GOE/donors) • Include district and governorate officials NMMS-SOTA-1

  7. Program Component & Lessons Learned • Develop QA system • Train on service standards (facility, equipment performance) • Develop clinical indicators • Implement community activity/NGO grants • Use existing local committees • Involve community in needs assessment studies • Outreach work through NGOs • Conduct Mass Media Campaigns/IEC • Mass media campaign • Low literacy materials (pamphlets and posters) NMMS-SOTA-1

  8. Socio-demographic and other health indicators NMMS-SOTA-1

  9. Conclusion • The dramatic decline in maternal mortality is the result of several direct and indirect factors. Further decline requires continued commitment and sustained efforts to: • Improve access to family planning; • Educate women about seeking appropriate medical care; • Improve quality of obstetric care. NMMS-SOTA-1

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