Browsing by Author "Weeks, Andrew"

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    Exploring the Third Delay: An Audit Evaluating Obstetric Triage at Mulago National Referral Hospital
    (BMC Pregnancy and Childbirth, 2016) Forshaw, Jennifer; Raybould, Stephanie; Muyingo, Mark; Weeks, Andrew; Byamugisha, Josaphat
    Mulago National Referral Hospital has the largest maternity unit in sub-Saharan Africa. It is situated in Uganda, where the maternal mortality ratio is 310 per 100,000 live births. In 2010 a ‘Traffic Light System’ was set up to rapidly triage the vast number of patients who present to the hospital every day. The aim of this study was to evaluate the effectiveness of the obstetric department’s triage system at Mulago Hospital with regard to time spent in admissions and to identify urgent cases and factors adversely affecting the system.
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    Personal accounts of ‘near-miss’ maternal mortalities in Kampala, Uganda
    (An International Journal of Obstetrics & Gynaecology, 2005) Weeks, Andrew; Lavender, Tina; Nazziwa, Enid; Mirembe, Florence
    To explore the socio-economic determinants of maternal mortality in Uganda through interviews with women who had ‘near misses’. Design Observational study using qualitative research methods. Setting The postnatal and gynaecology wards of a large government hospital in Kampala, Uganda. Sample Thirty women who had narrowly avoided maternal deaths with diagnoses of obstructed labour (7), severe pre-eclampsia/eclampsia (3), post caesarean infection (6), haemorrhage (5), ectopic pregnancy (5) and septic abortion (4). Methods The semi-structured interviews were conducted in the local language by a woman unconnected to the hospital, and were recorded before being translated and transcribed. Analysis was conducted in duplicate using commercial software. Results The predominant theme was powerlessness, which occurred both within and outside the hospital. It was evident in the women’s attempts to get both practical and financial help from those around them as well as in their failure to gain rapid access to care. Financial barriers and problems with transport primarily governed health-seeking behaviour. Medical mistakes and delays in referral were evident in many interviews, especially in rural health centres. Women were appreciative of the care they received from the central government hospital, although there were reports of overcrowding, long delays, shortages and inhumane care. There were no reports of bribery. Conclusions Women with near-miss maternal mortalities experience institutional and social powerlessness: these factors may be a major contributor to maternal mortality.