Journal Articles

JSI staff regularly publish their research and results from work in peer-reviewed journals. This section provides a brief abstract with a link to the journal where you can read more and either download or order the article, depending on the journal.

2017   |   2016   |   All Journal Articles

February 2017

Implementing at-scale, community-based distribution of misoprostol tablets to mothers in the third stage of labor for the prevention of postpartum haemorrhage in Sokoto State, Nigeria: Early results and lessons learned in PLoS ONE 12(2): e0170739.

Postpartum haemorrhage (PPH) is a leading cause of maternal death in Sokoto State, Nigeria, where 95% of women give birth outside of a health facility. Although pilot schemes have demonstrated the value of community-based distribution of misoprostol for the prevention of PPH, none have provided practical insight on taking such programs to scale. A community-based system for the distribution of misoprostol tablets and chlorhexidine digluconate gel to mother-newborn dyads was introduced by state government officials and community leaders throughout Sokoto State in April 2013. A simple outcome form that collected distribution and consumption data was used to assess the percentage of mothers that received misoprostol at labor through December 2014. Mothers' conditions were tracked through 6 weeks postpartum. Verbal autopsies were conducted on associated maternal deaths.

Misoprostol distribution was successfully introduced and reached mothers in labor in all 244 wards in Sokoto State. Community data collection systems were successfully operational in all 244 wards with reliable capacity to record maternal deaths. 70,982 women or 22% of expected births received misoprostol from April 2013 to December 2014.

It was concluded that it is feasible and safe to utilize government guidelines on results-based primary health care to successfully introduce community distribution of life saving misoprostol at scale to reduce PPH and improve maternal outcomes. Lessons from Sokoto State's at-scale program implementation, to assure every mother's right to uterotonics, can inform scale-up elsewhere in Nigeria.
Authors: Nosakhare Orobaton, Jumare Abdulazeez, Dele Abegunde, Kamil Shoretire, Abubakar Maishanu, Nnenna Ikoro, Bolaji Fapohunda, Wapada Balami, Katherine Beal, Akeem Ganiyu, Ringpon Gwamzhi, Anne Austin

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January 2017

Geographic information system for improving maternal and newborn health: recommendations for policy and programs in BMC Pregnancy and Childbirth, (2017) 17:26.

In a letter to the editor of BMC Pregnancy and Chgildbirth, JSI staff and other authors argue and offer recommendations for how geographic information systems (GIS) applied to maternal and newborn health data could potentially be used as part of the broader efforts for ending preventable maternal and newborn mortality.

The recommendations were generated from a technical consultation on reporting and mapping maternal deaths that was held in Washington, DC from January 12 to 13, 2015 and hosted by the USAID-funded Maternal and Child Survival Program (MCSP). Approximately 72 participants participated in the meeting, which focused on how improved use of mapping could contribute to the post-2015 United Nation’s Sustainable Development Goals (SDGs) agenda in general and to better maternal and neonatal health outcomes in particular.

Researchers and policy makers have been calling for more equitable improvement in maternal and newborn health (MNH), specifically addressing hard-to-reach populations at sub-national levels. Data visualization using mapping and geospatial analyses play a significant role in addressing the emerging need for improved spatial investigation at subnational scale. This correspondence identifies key challenges and recommendations so GIS may be better applied to maternal health programs in resource poor settings. The challenges and recommendations are broadly grouped into three categories: ancillary geospatial and MNH data sources, technical and human resources needs and community participation.

Authors: Yordanos Molla, Barbara Rawlins, Prestige Tatenda Makanga, Marc Cunningham, Juan Eugenio Hernandez Avila, Corrine Warren Ruktanonchai, Kavita Singh, Sylvia Alford, Mira Thompson, Vikas Dwivedi, Allisyn C. Moran, and Zoe Matthews.

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