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