Maternal emergencies without a safety net
Researchers look for answers to high maternal and neonatal mortality
rates in East Africa

Date:
October 6, 2021
Source:
University of Minnesota
Summary:
For millions of people living in rural communities in sub-Saharan
Africa, accessing timely care during maternal and neonatal
emergencies remains a complex problem.



FULL STORY ==========================================================================
The isolated Suba and Luo communities of Mfangano Island on Lake Victoria
in Western Kenya experience some of the highest maternal and neonatal
mortality rates in East Africa. To understand factors at the heart of
this complex challenge, researchers from the University of Minnesota
have partnered with one of the most remote and underserved populations
in the world.


========================================================================== Published in Global Public Health, the Monitoring Maternal Emergency
Navigation and Triage on Mfangano (MOMENTUM) Study uses an innovative
adaptive design to measure delays and barriers faced by mothers and
newborns seeking emergency care.

Since 2018, Charles Salmen, MD, director of the Mfangano Community Health
Field Station and assistant professor in the Department of Family Medicine
and Community Health at the Medical School, and Co-Principal Iinvestigator Louisa Ndunyu, PhD, of Maseno University in Kenya, have mentored a team
of local and international investigators to launch the MOMENTUM Study. At
the same time, the study was designed to provide pragmatic, actionable
data to support a locally- directed health navigation program serving
this remote population. Through a 12-month, mixed-methods cohort study,
the group of local and international investigators evaluated barriers
and delays among patients seeking care for pregnancy-related, obstetric,
and neonatal emergencies at nine remote health centers within Mfangano
Island Division.

"The study was nearly derailed by the start of the COVID-19 pandemic
in the middle of our data collection period. Yet through all, and
thanks to the ingenuity and dedication of our team on the ground,
and the remote support from our team at the University of Minnesota,
we persevered to ensure that the harrowing stories of these mothers and
their families were preserved and understood," said Salmen. "Because they
were willing to share their experiences from beginning to end, this study
now represents an important contribution towards addressing the vexing
problem of maternal emergencies in sub-Saharan Africa." The MOMENTUM
study points to an urgent need for community education efforts regarding awareness of emergency conditions, implementation of streamlined hand-off systems for emergency referrals, as well as policy level interventions
to address the recurrent health worker strikes. Particularly, in light of frequent facility closures and staffing interruptions, the study suggests
a critical role for community-based care coordinators. The study suggests
that these recurrent gaps can, in fact, be bridged by local interventions
that flexibly connect the dots for families and providers across dynamic
care environments, syncing communication and facilitating timely transport
to available resources, and above all, advocating for patients.

With the completion of the first round of quantitative data analysis,
the team in Kenya is currently conducting focus group discussions and
key informant interviews to understand how the COVID-19 pandemic has
impacted maternal and neonatal emergency care on Lake Victoria. This
research is led by Kenyan investigators from Maseno University, local
research staff at the Ekialo Kiona Center, with remote support from a
team of University of Minnesota medical and public health students.

========================================================================== Story Source: Materials provided by University_of_Minnesota. Original
written by Gao Vang.

Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Charles Reinisch Salmen, Louisa Ndunyu, John M. Ssenkusu, David
Marshall,
Nicholas DesLauriers, Ananda Vigneswari Anebarassou, Evance Ogola,
Gor Benard Ouma, Brian Mattah, Robinson Okeyo, Scholarstica
Otieno, Nyika Friberg, Lily Muldoon, Kelsi Hines, Marcus Salmen,
Shailendra Prasad.

Falling through the net: An adaptive assessment of the
`Three Delays' encountered by patients seeking emergency
maternal and neonatal care within a remote health system
on Lake Victoria, Kenya. Global Public Health, 2021; 1 DOI:
10.1080/17441692.2021.1966640 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/10/211006143436.htm

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