Introduction: Through forensic auditing a new way to monitor medical data was opened. Forensic auditing uses Benford’s law, which explains the frequency distribution in naturally occurring data sets. We applied this ...Introduction: Through forensic auditing a new way to monitor medical data was opened. Forensic auditing uses Benford’s law, which explains the frequency distribution in naturally occurring data sets. We applied this law on data for Maternal Mortality. This is an extremely important number in policy-making for sustainable project implementation. Methodology: The law states that the probability of a leading occurring number can be calculated through the following equation: observed and expected values were compared. To confirm statistical significance examination we used the Chi-square test. Results: The chi-square value for MMR was 21.08 for the 2012 report and 19.97 for the 2014 report. Chi-square was higher than the cut off value, which leads to the rejection the null hypothesis. The rejection of the null hypothesis means that the numbers observed in the publication are not following Benford’s law. Explanations can reach from errors, operational discrepancies and psychological challenges to manipulations in the struggle for international funding. Conclusion: Knowledge on this mathematical relation is not used widely in medicine, despite being a very valuable and quick tool to identify datasets in need of close scrutiny.展开更多
China, as a whole, is about to meet the Millennium Development Goals for reducing the maternal mortality ratio (MMR) and infant mortality rate (IMR), but the disparities between rural area and urban area still exists....China, as a whole, is about to meet the Millennium Development Goals for reducing the maternal mortality ratio (MMR) and infant mortality rate (IMR), but the disparities between rural area and urban area still exists. This study estimated the potential effectiveness of expanding coverage with high impact interventions using the Lives Saved Tool (LiST). It was found that gestational hypertension, antepartum and postpartum hemorrhage, preterm birth, neonatal asphyxia, and neonatal childhood pneumonia and diarrhea are still the major killers of mothers and children in rural area in China. It was estimated that 30% of deaths among 0-59 month old children and 25% of maternal deaths in 2008 could be prevented in 2015 if primary health care intervention coverage expanded to a feasible level. The LiST death cause framework, compared to data from the Maternal and Child Mortality Surveillance System, represents 60%-80% of neonatal deaths, 40%-50% of deaths in 1-59 month old children and 40%-60% of maternal deaths in rural areas of western China.展开更多
Since the People’s Republic of China founded,especially over the last 15 years,maternal mortality rate(MMR)has fallen dramatically.In 2014,China has achieved the target of a reduction of 75%MMR from 1990 to 2015(MDG ...Since the People’s Republic of China founded,especially over the last 15 years,maternal mortality rate(MMR)has fallen dramatically.In 2014,China has achieved the target of a reduction of 75%MMR from 1990 to 2015(MDG 5)ahead of schedule.This achievement can be attributed to the improvement of legislation and policy,government commitment and investment on maternal health,extensive international cooperation,implementation of the maternal health program,development of maternal and child health(MCH)service system and development of MCH surveillance systems.Although China has achieved MDG 5,there are many kinds of difficulties and challenges in achieving the post-2015 Sustainable Development Goals(SDGs).Therefore,multi-strategy actions need to be considered to seize the opportunities to further reduce the MMR in the future.展开更多
Background: Home deliveries is still high globally at 42% WHO 2022, due to high home deliveries, maternal death is also high at 43% globally. In sub-Sahara region home deliveries still high. Giving birth at health fac...Background: Home deliveries is still high globally at 42% WHO 2022, due to high home deliveries, maternal death is also high at 43% globally. In sub-Sahara region home deliveries still high. Giving birth at health facilities in most of sub-Saharan African countries Zambia inclusive is still a challenge whereby more than 51% of first-time mothers give birth at home and this gives a risk of high maternal and perinatal deaths. Therefore Reducing number of home deliveries is important to improve maternal and perinatal health issues. In this study, the aim was to investigate the determinants of home deliveries by pregnant mothers in the Luumbo zone of Gwembe district, Zambia. Purpose: Access to skilled care and facilities with capacity to provide emergency and newborn care is critical to reduce maternal death. In Zambia 42% of women still deliveries from home, suggesting a persistent challenge for women to seek, reach, and receive quality maternity care. This study aimed investigate the determinants of home deliveries by pregnant mothers in Luumbo zone of Gwembe district, Zambia. Methods: The study was conducted among postnatal mothers who came for postnatal care at 6 weeks in Luumbo Chabbobboma clinic in Gwembe district southern province of Zambia. This was a descriptive cross-sectional study where a Simple random sampling technique was used to select 105 women of childbearing age who attended postnatal and had a recent delivery. Data were collected using a researcher-administered structured questionnaire to identify determinants of home deliveries in Luumbo Chabbobboma zone. Data analysis was done using SPSS computer software version 27.0. Both descriptive and inferential (chi-square test) analyses were performed and statistical significance was taken at α ≤ 0.05. Results: The results show that 46 (43.8%) respondents were in the age bracket 20 - 29 years. Of the 105 respondents included in the study, 24 (22.9%) of them delivered from home. The results show that high maternal age (p = 0.03), occupation (p = 0.024), distance to the facility (p = 0.014), means of transportation (p = 0.023), multiparity (p = 0.01), timing and number of ANC visits (p Conclusion: From this population. The major reason why women still deliver at home was long distance to the nearest facility. To reduce maternal and perinatal mortality access to health facilities by pregnant women needs to be improved. There should also be active engagement of the traditional and religious institutions in the area.展开更多
文摘Introduction: Through forensic auditing a new way to monitor medical data was opened. Forensic auditing uses Benford’s law, which explains the frequency distribution in naturally occurring data sets. We applied this law on data for Maternal Mortality. This is an extremely important number in policy-making for sustainable project implementation. Methodology: The law states that the probability of a leading occurring number can be calculated through the following equation: observed and expected values were compared. To confirm statistical significance examination we used the Chi-square test. Results: The chi-square value for MMR was 21.08 for the 2012 report and 19.97 for the 2014 report. Chi-square was higher than the cut off value, which leads to the rejection the null hypothesis. The rejection of the null hypothesis means that the numbers observed in the publication are not following Benford’s law. Explanations can reach from errors, operational discrepancies and psychological challenges to manipulations in the struggle for international funding. Conclusion: Knowledge on this mathematical relation is not used widely in medicine, despite being a very valuable and quick tool to identify datasets in need of close scrutiny.
基金supported jointly by WHO(CHN-12-MCN-005007)UNICEF(YH702H&N)Chinese Post-doctoral Foundation(2012M510295)
文摘China, as a whole, is about to meet the Millennium Development Goals for reducing the maternal mortality ratio (MMR) and infant mortality rate (IMR), but the disparities between rural area and urban area still exists. This study estimated the potential effectiveness of expanding coverage with high impact interventions using the Lives Saved Tool (LiST). It was found that gestational hypertension, antepartum and postpartum hemorrhage, preterm birth, neonatal asphyxia, and neonatal childhood pneumonia and diarrhea are still the major killers of mothers and children in rural area in China. It was estimated that 30% of deaths among 0-59 month old children and 25% of maternal deaths in 2008 could be prevented in 2015 if primary health care intervention coverage expanded to a feasible level. The LiST death cause framework, compared to data from the Maternal and Child Mortality Surveillance System, represents 60%-80% of neonatal deaths, 40%-50% of deaths in 1-59 month old children and 40%-60% of maternal deaths in rural areas of western China.
文摘Since the People’s Republic of China founded,especially over the last 15 years,maternal mortality rate(MMR)has fallen dramatically.In 2014,China has achieved the target of a reduction of 75%MMR from 1990 to 2015(MDG 5)ahead of schedule.This achievement can be attributed to the improvement of legislation and policy,government commitment and investment on maternal health,extensive international cooperation,implementation of the maternal health program,development of maternal and child health(MCH)service system and development of MCH surveillance systems.Although China has achieved MDG 5,there are many kinds of difficulties and challenges in achieving the post-2015 Sustainable Development Goals(SDGs).Therefore,multi-strategy actions need to be considered to seize the opportunities to further reduce the MMR in the future.
文摘Background: Home deliveries is still high globally at 42% WHO 2022, due to high home deliveries, maternal death is also high at 43% globally. In sub-Sahara region home deliveries still high. Giving birth at health facilities in most of sub-Saharan African countries Zambia inclusive is still a challenge whereby more than 51% of first-time mothers give birth at home and this gives a risk of high maternal and perinatal deaths. Therefore Reducing number of home deliveries is important to improve maternal and perinatal health issues. In this study, the aim was to investigate the determinants of home deliveries by pregnant mothers in the Luumbo zone of Gwembe district, Zambia. Purpose: Access to skilled care and facilities with capacity to provide emergency and newborn care is critical to reduce maternal death. In Zambia 42% of women still deliveries from home, suggesting a persistent challenge for women to seek, reach, and receive quality maternity care. This study aimed investigate the determinants of home deliveries by pregnant mothers in Luumbo zone of Gwembe district, Zambia. Methods: The study was conducted among postnatal mothers who came for postnatal care at 6 weeks in Luumbo Chabbobboma clinic in Gwembe district southern province of Zambia. This was a descriptive cross-sectional study where a Simple random sampling technique was used to select 105 women of childbearing age who attended postnatal and had a recent delivery. Data were collected using a researcher-administered structured questionnaire to identify determinants of home deliveries in Luumbo Chabbobboma zone. Data analysis was done using SPSS computer software version 27.0. Both descriptive and inferential (chi-square test) analyses were performed and statistical significance was taken at α ≤ 0.05. Results: The results show that 46 (43.8%) respondents were in the age bracket 20 - 29 years. Of the 105 respondents included in the study, 24 (22.9%) of them delivered from home. The results show that high maternal age (p = 0.03), occupation (p = 0.024), distance to the facility (p = 0.014), means of transportation (p = 0.023), multiparity (p = 0.01), timing and number of ANC visits (p Conclusion: From this population. The major reason why women still deliver at home was long distance to the nearest facility. To reduce maternal and perinatal mortality access to health facilities by pregnant women needs to be improved. There should also be active engagement of the traditional and religious institutions in the area.
