wow-inequalities/02-data/intermediate/wos_sample/c6b1d42804678b8943bd420e5f14d298-slezak-emilia-and-u/info.yaml

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2023-09-28 14:46:10 +00:00
abstract: 'Background Maternal morbidity and mortality related to infection is an
international public health concern, but detection and assessment is
often difficult as part of routine maternity care in many low- and
middle-income countries due to lack of easily accessible diagnostics.
Front-line healthcare providers are key for the early identification and
management of the unwell woman who may have infection. We sought to
investigate the knowledge, attitudes, and perceptions of the use of
screening tools to detect infectious maternal morbidity during and after
pregnancy as part of routine antenatal and postnatal care. Enabling
factors, barriers, and potential management options for the use of early
warning scores were explored. Methods Key informant interviews (n = 10)
and two focus group discussions (n = 14) were conducted with healthcare
providers and managers (total = 24) working in one large tertiary public
hospital in Blantyre, Malawi. Transcribed interviews were coded by topic
and then grouped into categories. Thematic framework analysis was
undertaken to identify emerging themes. Results Most healthcare
providers are aware of the importance of the early detection of
infection and would seek to better identify women with infection if
resources were available to do so. In current practice, an early warning
score was used in the high dependency unit only. Routine screening was
not in place in the antenatal or postnatal departments. Barriers to
implementing routine screening included lack of trained staff and time,
lack of thermometers, and difficulties with the interpretation of the
early warning scores. A locally adapted early warning screening tool was
considered an enabler to implementing routine screening for infectious
morbidity. Local ownership and clinical leadership were considered
essential for successful and sustainable implementation for clinical
change. Conclusions Although healthcare providers considered infection
during and after pregnancy and childbirth a danger sign and significant
morbidity, standardised screening for infectious maternal morbidity was
not part of routine antenatal or postnatal care. The establishment of
such a service requires the availability of free and easy to access
rapid diagnostic testing, training in interpretation of results, as well
as affordable targeted treatment. The implementation of early warning
scores and processes developed in high-income countries need careful
consideration and validation when applied to women accessing care in low
resource settings.'
affiliation: 'McCauley, M (Corresponding Author), Liverpool Womens Hosp, Liverpool
Womens NHS Fdn Trust, Crown St, Liverpool L8 7SS, Merseyside, England.
Slezak, Emilia; Unger, Holger; McCauley, Mary, Univ Liverpool Liverpool Sch Trop
Med, Ctr Maternal \& Newborn Hlth, Liverpool, Merseyside, England.
Unger, Holger, Royal Darwin Hosp, Dept Obstet \& Gynaecol, Darwin, NT, Australia.
Unger, Holger, Charles Darwin Univ, Menzies Sch Hlth Res, Darwin, NT, Australia.
Gadama, Luis, Queen Elizabeth Hosp, Blantyre, Malawi.
McCauley, Mary, Liverpool Womens Hosp, Liverpool Womens NHS Fdn Trust, Crown St,
Liverpool L8 7SS, Merseyside, England.'
article-number: '362'
author: Slezak, Emilia and Unger, Holger and Gadama, Luis and McCauley, Mary
author-email: mary.mccauley1@lwh.nhs.uk
author_list:
- family: Slezak
given: Emilia
- family: Unger
given: Holger
- family: Gadama
given: Luis
- family: McCauley
given: Mary
da: '2023-09-28'
doi: 10.1186/s12884-022-04583-5
eissn: 1471-2393
files: []
journal: BMC PREGNANCY AND CHILDBIRTH
keywords: 'Maternal morbidity; Infections; Early warning scores; Healthcare
providers; Antenatal care; Postnatal care; SARS-CoV-2'
keywords-plus: 'INFLAMMATORY RESPONSE SYNDROME; WARNING SYSTEM; IMPLEMENTATION;
BARRIERS; MORTALITY; CRITERIA; OUTCOMES; IMPROVE; SEPSIS; EWS'
language: English
month: APR 26
number: '1'
number-of-cited-references: '50'
papis_id: ad7c99957940742ad1d87e68e2a54a21
ref: Slezak2022screeninginfectious
times-cited: '1'
title: 'Screening for infectious maternal morbidity-knowledge, attitudes and perceptions
among healthcare providers and managers in Malawi: a qualitative study'
2023-10-01 08:15:07 +00:00
type: article
2023-09-28 14:46:10 +00:00
unique-id: WOS:000787760200003
usage-count-last-180-days: '0'
usage-count-since-2013: '1'
volume: '22'
web-of-science-categories: Obstetrics \& Gynecology
year: '2022'