Introduction
Currently maternal issues make up one of the most critical global-health challenges. Consequently, this health issue was included in the globally sanctioned Millennium Development Goals (MDGs). According to the MDGs, the world endeavored to reduce instances of maternal mortality by at least 75% in the year 2015. However, this goal was not nearly achieved and maternal health is still a global health challenge. The problem of maternal health is particularly severe within developing countries where “and complications during pregnancy and childbirth remain a leading cause of death and disability among women of reproductive age” (Rasch, 2011). Current statistics also indicate that ninety-five percent of maternal heaths happen in developing nations. Post maternal health is another issue that applies to global health. Complications that occur as a result of maternal health issues can lead to short-term complications, infertility, disability, or even death. The issue of maternal health cannot be addressed through a single intervention, but they require a concerted effort of all healthcare stakeholders.
Healthcare professionals have the capacity to make a big impact on the issue of maternal health. Nurses are strategically placed in the issue of maternal health because they form the majority of antenatal, prenatal, and midwifery healthcare staff. Educating nurses and other maternal health staff strengthens healthcare mechanisms thereby improving maternal healthcare. The Maternal Mortality group estimates that there were an estimated five hundred thousand maternal-deaths in the year 2011. These figures could be higher because most maternal deaths occur in remote areas and they are mostly unreported. This paper is a review of literature on some of the recent research in maternal-health interventions and outcomes, in regards to the role that nurses can play in improving this issue. The literature review will include results from various research studies from around the world. Furthermore, the review will pay special attention to community health issues that mostly apply to women. The review will address how nurses can affect the outcomes of maternal health issues. Through this review of literature, healthcare professionals around the world, especially at-risk areas can adopt measures that can help them to improve maternal health. The reviewed articles are peer-reviewed studies from nursing health and academic databases and international agencies.
Maternal Health Issues in United States and around the World
Although the issue of maternal health in the United States is not a pressing issue than in other countries around the world, its effects continue to be felt across the country. For instance, the United States is ranked fortieth when it comes to maternal health deaths. The fact that the Unites States has allocated the most resources on maternal health among global countries means that the country is not performing as expected. Furthermore, most maternal health cases in the United States are often recorded as part of other health issues. Currently, the country does not have any solid data systems that are strictly connected to maternal health. Experts have claimed that the country’s health system is liable for some of the maternal deaths that continue to occur throughout the country today. In the year 2000, the United States Department of Health and Human Services set a goal that aimed to reduce instances of maternal death to less than three deaths in each one hundred thousand live births in the next ten years. The fact that this goal was not achieved indicates that the United States requires some improvements when it comes to maternal health. Nevertheless, this need is well represented through various health initiatives and maternal health data. A majority of the missed maternal health opportunities in the United States are closely related to postpartum healthcare.
African countries are the most affected when it comes to maternal health. Statistics concerning maternal issues are closely related across most African countries such as Uganda, Ghana, and Mozambique among others. Consequently, most African countries approach the issue of maternal health from similar perspectives. Maternal health in Africa is going through a revolution. Therefore, most countries are in the process of updating their health programs and protocols with the aim of equipping nurses and other practitioners with the best practices. Currently, only a handful of countries across Africa have been successful in guaranteeing the provision of comprehensive maternal services as well as adequate newborn healthcare. Nevertheless, lack of skilled healthcare professionals is still biggest challenge to maternal health in most African countries. For instance, traditional birth assistants are common in most African countries especially in rural areas. Major healthcare stakeholders around the world have recognized the role played by these traditional midwifes and they have sought to improve maternal health through these professionals. In the past, “WHO and other health agencies (UNFPA, UNICEF) promoted training of traditional birth professionals in order to improve access to safe delivery and scale up” (Rasch, 2011, p. 11).
Cheng, C. Y., Fowles, E. R., & Walker, L. O. (2006). Postpartum maternal health care in the United States: A critical review. The Journal of Perinatal Education, 15(3), 34-42.
The first Study is titled “Postpartum Maternal Health Care in the United States: A Critical Review” and it is jointly authored by various registered nurses and scholars. According to the study, postpartum maternal healthcare has not generated the attention it requires in the United States’ health fraternity. The researchers cite the lack of adequate national-health initiatives when it comes to maternal health as the main motivation behind their choice of research topic. According to the study, there is enough data to indicate that standardized postpartum care is not adequate as far as wholesome maternal health is concerned. The article also points to the differences in maternal health perceptions between mothers and nursing professionals. Consequently, the researchers find the necessity of “collecting national data on postpartum maternal morbidity, reforming postpartum care policies, providing holistic and flexible maternal health care, encouraging family support and involvement in support groups, and initiating educational programs” (Cheng, Fowles, & Walker, 2006).
This study accurately points out the gap that is created by the neglect of postpartum health aspects. Lack of relevant data on postpartum health makes it hard to gauge the severity of this issue. However, the authors of this study offer solid data on how postpartum health can affect the health of both mothers and newborns. The interventions that are provided in this study can offer nurses new insights into the subject of postpartum maternal-health. Some of these interventions such as provision of psychological support can be applied in day-to-day nursing activities.
Blum, L. (2006). Attending home versus Clinic based deliveries; perspectives of SBAs in Matlab, Bangladesh. Reproductive Health Matters, 14(27); 51-60
This study assesses the merits and demerits of using home-based deliveries versus clinic-based ones in regards to overall maternal health. The study focused on the population of rural Matlab, Bangladesh and it was first published in the “Journal of Reproductive Health Matters”. The study was qualitative and it and it employed the experiences of various skilled birth attendants (SBAs) who had engaged in both clinical and home based deliveries. The findings of this research indicated that home-based deliveries were subject to various constraints such as lack of emergency transport, supplies, and supervision among others (Blum, 2006). Furthermore, the study found that even in cultural settings it is important to foster an enabling environment.
The authors of this study strongly suggest that in regions where homebirths are norm, professional training of SBAs would go a long way in improving maternal health. This study also provides a simple solution whose implementation would have big impacts on maternal health. Furthermore, the findings of this study can be easily integrated to mainstream community health programs at low costs. For example, in areas where homebirths are common professional nurse training can encompass these findings.
Bazzano, A. N., Kirkwood, B., & Adongo, P. (2008). Social costs of skilled attendance at birth in rural Ghana. International Journal of Gynecology & Obstetrics, 102(1), 91-94.
This study was commissioned by the World Health Organization (WHO) and the Department for International Development (DFID) to be utilized by medical students in the United Kingdom. The study analyzes the costs of skilled birth attendance in a district in Ghana. The study involved several health facilities in Kintampo District and it involved interviews, questionnaires, expert analyses, and case histories (Bazzano, Kirkwood & Adongo, 2008). The researchers found that traditional birth attendants are often valued more than SBAs. Therefore, both social and financial costs of SBAs were high among women in the rural areas.
This study utilizes a combination of methodologies that are all aimed to reveal the cost that comes with enlisting the services of an SBA in rural Ghana. Eventually, the high social and economic costs of SBAs end up compromising the integrity of maternal health. This issue rarely applies to societies in developed countries. Consequently, the issue can only be solved through expansive social-education programs. This study also provides a new way of tackling maternal health issues by highlighting the social barriers that apply to child delivery practices around the world. This approach would have a significant impact on the uniformity of maternal health issues around the world.
Gaskin, I. M. (2008). Maternal death in the United States: a problem solved or a problem ignored?. The Journal of Perinatal Education, 17(2), 9-13.
This study seeks to highlight the unaddressed aspects of maternal death statistics in the United States. The author of this paper is a certified midwife and a renown authority in maternal health. According to the author, there is a certain level of laxity when considering the issue of maternal mortality in the United States. Healthcare stakeholders are operating under the perception that the issue does not warrant any significant attention. The research utilizes case studies to indicate some of the misconceptions that apply to maternal death records in the United States. The author also compares the situation in the United States to the one in the United Kingdom.
This article provides practical insights to a problem that has for a long time been overlooked by healthcare stakeholders in the United States. The experience and position of the author adds credibility to the research and prompts nurses and midwives to consider the issue from new perspectives.
Conclusion
Maternal health is a pertinent issue in the global context. Nevertheless, the issue is more relevant to areas where healthcare has not fully evolved such as some parts of Asia and Africa. Maternal health is also a broad topic that covers topics such as maternal mortality, postpartum health, and healthcare economics among others. The most important factor in the consideration of healthcare is nursing interventions because nurses have a relatively close proximity to the issue.
References
Bazzano, A. N., Kirkwood, B., & Adongo, P. (2008). Social costs of skilled attendance at birth in rural Ghana. International Journal of Gynecology & Obstetrics, 102(1), 91-94.
Blum, L. (2006). Attending home versus Clinic based deliveries; perspectives of SBAs in Matlab, Bangladesh. Reproductive Health Matters, 14(27); 51-60
Cheng, C. Y., Fowles, E. R., & Walker, L. O. (2006). Postpartum maternal health care in the United States: A critical review. The Journal of Perinatal Education, 15(3), 34-42.
Gaskin, I. M. (2008). Maternal death in the United States: a problem solved or a problem ignored?. The Journal of Perinatal Education, 17(2), 9-13.
Rasch, V. (2011). Maternal death and the millennium development goals. Dan Med Bull, 54(2), 167-169.