Development of a clinical prediction model for perinatal deaths in low resource settings

Unraveling the Determinants of Maternal Well-Being Among Tribal Populations of Kerala: A Systematic Review

BACKGROUND

Despite Kerala's noteworthy achievements in health indices, the tribal population in the state continues to face significant challenges in achieving optimal health outcomes. This is particularly evident in the realm of maternal health, where tribal communities struggle. In light of this paradox, a systematic review was conducted to identify the factors influencing the quality of tribal maternal health and their determinants.

METHOD

A comprehensive search strategy was employed, utilizing computer-backed searches of eminent bibliographic databases, along with the exploration of additional cited references and hand-searching of relevant journals. The methodological quality of the selected studies was rigorously assessed through a transparent cataloguing system and analysis by reviewers, resulting in the inclusion of thirty studies following the filtering process. The selected studies were subjected to detailed analysis to identify the determinants of maternal health among tribal populations.

RESULTS

Thematic analysis of thirty studies that met the inclusion criteria resulted in four sets of determinants that contribute to maternal health among tribal women; biological/demographic determinants, psychological determinants, social determinants, and cultural determinants.

CONCLUSIONS

This review provides a comprehensive picture of tribal maternal health in Kerala, shedding light on their multifaceted challenges. The study provides a basis for the formulation of initiatives by addressing the broader determinants of health and accounting unique socio-cultural factors influencing well-being of tribal communities.

Maternal perception of fetal movements: Views, knowledge and practices of women and health providers in a low-resource setting

The study assessed perception, knowledge, and practices regarding maternal perception of fetal movements (FMs) among women and their healthcare providers in a low-resource setting. Semi-structured interviews, questionnaires and focus group discussions were conducted with 45 Zanzibar women (18 antenatal, 28 postpartum) and 28 health providers at the maternity unit of Mnazi Mmoja Hospital, Zanzibar, Tanzania. Descriptive and thematic analyses were conducted to systematically extract subthemes within four main themes 1) knowledge/awareness, 2) behavior/practice, 3) barriers, and 4) ways to improve practice. Within the main themes it was found that 1) Women were instinctively aware of (ab)normal FM-patterns and healthcare providers had adequate knowledge about FMs. 2) Women often did not know how to monitor FMs or when to report concerns. There was inadequate assessment and management of (ab)normal FMs. 3) Barriers included the fact that women did not feel free to express concerns. Healthcare providers considered FM-awareness among women as low and unreliable. There was lack of staff, time and space for FM-education, and no protocol for FM-management. 4) Women and health providers recognised the need for education on assessment and management of (ab)normal FMs. In conclusion, women demonstrated adequate understanding of FMs and perceived abnormalities of these movements better than assumed by health providers. There is a need for more evidence on the effect of improving knowledge and awareness of FMs to construct evidence-based guidelines for low resource settings.