Views from the Frontline of Maternal Healthcare: Over 2000 Practitioners Worldwide Make Their Voices Heard!

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By: Hannah Knight, Community Moderator for Global Voices for Maternal Health at the University of Oxford

An online project, run by the Oxford Maternal & Perinatal Health Institute and Nuffield Department of Obstetrics & Gynaecology, University of Oxford, has recently sought the expert views of over 2000 healthcare providers in 91 countries so as to identify: a) barriers to providing best-practice care in maternal health and b) potential solutions using an innovative‘crowdsourcing’ initiative.

The results of the Global Voices for Maternal Health study are expected to give new weight to the views of midwives, nurses and doctors on the frontline in the fight against preventable maternal deaths. The data, which are being collected over a 9-month period until March 2011, should provide a useful tool for implementing the required changes to health care delivery in these countries, as well as for advocacy and priority-setting purposes.

The participants were drawn from over 900 healthcare facilities worldwide, which together oversee approximately 2.5 million deliveries annually. As Principal Investigator, Dr. José Villar, said: “This represents one of the largest ever direct consultations with practitioners in the history of medicine regarding their views on how to improve the clinical care that they provide.”

Data analysed so far reveal low rates of uptake for several safe, effective and affordable interventions for the prevention and management of obstetric complications:

  • Almost 40% of respondents reported that the WHO’s six clean delivery principles (clean hands, clean delivery surface, clean perineum, clean cord cutting instrument, clean cord ties, and clean cord care of the newborn) were not routinely followed in their facility
  • Over 20% of respondents had never seen clinical practice guidelines for the active management of the third stage of labour
  • 35% of respondents revealed that magnesium sulphate was not routinely used to prevent fits in women with severe pre-eclampsia in their facility

The next stage of the analysis will be to examine the barriers that have been identified as playing an important role, to assess how improving access to these interventions can be achieved within developing country health systems. As Bill Gates recently said during a meeting of global Health Ministers in China, “If we don’t change the systems, even the best tools may do no good, because they may never get to the people who need them.”

The full results of the study, which is funded by the Maternal Health Task Force, are due to be published later this year.

For more information on the initiative, visit the GVMH website: