Publications by authors named "Pamela Lynam"

Article Synopsis
  • Poor quality of care at health facilities is a significant barrier for pregnant women in low-resource countries, leading to disrespectful treatment during labor and childbirth.
  • A study observed labor and delivery practices in Ethiopia, Kenya, Madagascar, Rwanda, and Tanzania, using standardized checklists to assess respectful care and identify instances of abuse.
  • While many women were treated respectfully, the study found notable issues like neglect, poor communication from providers, and instances of both verbal and physical abuse, highlighting the need for improved care quality.
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Objective: To assess the quality of facility-based active management of the third stage of labour in Ethiopia, Kenya, Madagascar, Mozambique, Rwanda and the United Republic of Tanzania.

Methods: Between 2009 and 2012, using a cross-sectional design, 2317 women in 390 health facilities were directly observed during the third stage of labour. Observers recorded the use of uterotonic medicines, controlled cord traction and uterine massage.

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Women living in Nairobi's informal settlements face a higher risk of maternal death than those living elsewhere in the country, and have limited knowledge of actions they can take to improve their chances of survival during pregnancy and childbirth. As one strategy to reach this high risk group, Jhpiego has implemented young mothers' clubs (YMCs). These clubs comprise mothers aged 18-30 who come together on a weekly basis to share experiences and solutions to their challenges while receiving health education from health facility staff and community health workers (CHWs).

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Quality Problem: Research in Kenya in the mid-1990s suggested poor quality family planning services and limited access to services. Clinical guidelines for family planning and reproductive health were published in 1991 and updated in 1997, but never widely distributed.

Choice Of Solution: Managers and trainers chose intensive, district-level training workshops to disseminate guidelines and update health workers on guideline content and best practices.

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