ملخص الدراسة:

Background: Maternal mortality is an important health indicator for the overall health of a population. This study_x000D__x000D_
assessed the causes and contributing factors to maternal mortality that occurred in the Gaza-Strip between July_x000D__x000D_
2014 and June 2015._x000D__x000D_
Methods: This is a retrospective study that used both quantitative and qualitative data. The data were collected_x000D__x000D_
from available medical records, investigation reports, death certificates, and field interviews with healthcare_x000D__x000D_
professionals as well as families._x000D__x000D_
Results: A total of 18 maternal mortalities occurred in Gaza between 1st July 2014 and June 30th 2015. Age at time_x000D__x000D_
of death ranged from 18 to 44 years, with 44.4% occurring before the age of 35 years. About 22.2% were_x000D__x000D_
primiparous, while 55.6% were grand multiparous women. The most common causes of death were sepsis,_x000D__x000D_
postpartum haemorrhage, and pulmonary embolism._x000D__x000D_
The most striking deficiency was very poor medical documentation which was observed in 17 cases (94%). In addition,_x000D__x000D_
poor communication between doctors and women and their families or among healthcare teams was noticed in nine_x000D__x000D_
cases (50%). These were repeatedly described by families during interviews. Further aspects surfacing in many interviews_x000D__x000D_
were distrust by families towards clinicians and poor understanding of health conditions by women. Other factors_x000D__x000D_
included socioeconomic conditions, poor antenatal attendance and the impact of the 2014 war._x000D__x000D_
Low morale among medical staff was expressed by most interviewed clinicians, as well as the fear of being blamed by_x000D__x000D_
families and management in case of adverse events. Substandard care and lack of appropriate supervision were also_x000D__x000D_
found in some cases._x000D__x000D_
Conclusions: This study revealed deficiencies in maternity care, some of which were linked to the socioeconomic_x000D__x000D_
situation and the 2014 war. Others show poor implementation of clinical guidelines and lack of professional skills in_x000D__x000D_
communication and teamwork. Specialised training should be offered for clinicians in order to improve these aspects._x000D__x000D_
However, the most striking deficiency was the extremely poor documentation, reflecting a lack of awareness among_x000D__x000D_
clinicians regarding its importance. Local policymakers should focus on systematic application of quality improvement_x000D__x000D_
strategies in order to achieve greater patient safety and further reductions in the maternal mortality rate.

توثيق المرجعي (APA)

Böttcher, Bettina, Abu-El-Noor, Nasser I., Aldabbour, Belal, Naim, Fadel N.,& Aljeesh, Yousef I. (2018). Maternal mortality in the Gaza strip: a look at causes and solutions. BMC Pregnancy and Childbirth, volume:18, No:396, 27262