Leiden University Scholarly Publications

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Heemelaar, S. (2023)

Maternal health in Namibia: Lessons learned from obstetric surveillance

Doctoral Thesis
Over the past decades increasing efforts have aimed to improve the health of pregnant women around the world. Namibia has made limited progress in reducing severe maternal outcomes. Aims of this thesis were to enhance implementation of a national obstetric surveillance system and assess requirements to improve maternal health in Namibia. The findings of chapters 2-7 provided insight into several important drivers of severe maternal outcome. The most important contributor of the high-incidence of severe maternal outcome in Namibia was poor quality of facility-based care and particularly vulnerable women appeared to be at higher risk of severe maternal outcome. Obstetric surveillance played a crucial role in obtaining these insights. Based on these, targeted recommendations could be formulated. The maternity care system needs to be strengthened, to enable health workers to provide universal coverage of good health care to all women in Namibia. It is therefore crucial the next step...Show moreOver the past decades increasing efforts have aimed to improve the health of pregnant women around the world. Namibia has made limited progress in reducing severe maternal outcomes. Aims of this thesis were to enhance implementation of a national obstetric surveillance system and assess requirements to improve maternal health in Namibia. The findings of chapters 2-7 provided insight into several important drivers of severe maternal outcome. The most important contributor of the high-incidence of severe maternal outcome in Namibia was poor quality of facility-based care and particularly vulnerable women appeared to be at higher risk of severe maternal outcome. Obstetric surveillance played a crucial role in obtaining these insights. Based on these, targeted recommendations could be formulated. The maternity care system needs to be strengthened, to enable health workers to provide universal coverage of good health care to all women in Namibia. It is therefore crucial the next step will follow, which is to act on the proposed recommendations. The insights obtained through obstetric surveillance will contribute to such action, as for any intervention, it is key it addresses a local need in a context-specific manner.
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Maternal mortality
Severe morbidity
Surveillance
Women's health
Namibia
Inequity
All authors
Heemelaar, S.
Supervisor
Lith, J.M.M. van; Akker, T.H. van den; Stekelenburg, J.
Committee
Yazdanbakhsh, M.; Roos-Hesselink, J.W.; Endjala, T.; Beltman, J.J.
Qualification
Doctor (dr.)
Awarding Institution
Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
Date
2023-04-18
ISBN (print)
9789464586688

Funding

Sponsorship
Financial support for printing of this thesis was kindly provided by the Department of Obstetrics and Gynaecology of Leiden University Medical Center, Walaeus University Library, Haaglanden Medical Center, Bayer, Titus Health Care, ChipSoft.