Dataset Information

Stillbirth in Lao PDR: a healthcare provider perspective.

ABSTRACT:

Background

Stillbirth is a major global concern. However, most research has been conducted in high-income countries. Understanding of the experience and management of stillbirth in low-middle income countries is needed.

Objective

This qualitative study explored health professionals' experiences of providing stillbirth care in the Lao People's Democratic Republic, a lower-middle-income country in South-East Asia.

Methods

In-depth interviews were conducted with 33 health professionals (doctors, midwives and nurses) and thematic analysis was undertaken.

Results

All participants acknowledged stillbirth as a concern, but its incidence and causes were largely undocumented and unknown. A lack of training in managing stillbirth left health professionals often ill-equipped to support mothers and provide responsive care. Social stigma surrounds stillbirth, meaning mothers found limited support or opportunities to openly express their grief.

Conclusions

Better awareness of stillbirth causes could promote more positive experiences for healthcare providers and parents and more responsive healthcare. This requires improved training for healthcare professionals and awareness raising in the wider community.

SUBMITTER: Choummanivong M

PROVIDER: S-EPMC7480497 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Stillbirth in Lao PDR: a healthcare provider perspective.

Choummanivong Molina M Karimi Sediqa S Durham Joanne J Sychareun Vanphanom V Flenady Vicki V Horey Dell D Boyle Fran F

Global health action 20200701 sup2

<h4>Background</h4>Stillbirth is a major global concern. However, most research has been conducted in high-income countries. Understanding of the experience and management of stillbirth in low-middle income countries is needed.<h4>Objective</h4>This qualitative study explored health professionals' experiences of providing stillbirth care in the Lao People's Democratic Republic, a lower-middle-income country in South-East Asia.<h4>Methods</h4>In-depth interviews were conducted with 33 health prof ...[more]

PMID: 32741353

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Project description:BackgroundDuring late 2012 and early 2013 several outbreaks of diphtheria were notified in the North of the Lao People's Democratic Republic. The aim of this study was to determine whether the re-emergence of this vaccine-preventable disease was due to insufficient vaccination coverage or reduction of vaccine effectiveness within the affected regions.MethodsA serosurvey was conducted in the Huaphan Province on a cluster sampling of 132 children aged 12-59 months. Serum samples, socio-demographic data, nutritional status and vaccination history were collected when available. Anti-diphtheria and anti-tetanus IgG antibody levels were measured by ELISA.ResultsOverall, 63.6% of participants had detectable diphtheria antibodies and 71.2% tetanus antibodies. Factors independently associated with non-vaccination against diphtheria were the distance from the health centre (OR: 6.35 [95% CI: 1.4-28.8], p = 0.01), the Lao Theung ethnicity (OR: 12.2 [95% CI:1,74-85, 4], p = 0.01) and the lack of advice on vaccination given at birth (OR: 9.8 [95% CI: 1.5-63.8], (p = 0.01) while the level of maternal edu-cation was a protective factor (OR: 0.08 [95% CI: 0.008-0.81], p = 0.03). Most respondents claimed financial difficulties as the main reason for non-vaccination. Out of 55 children whose vaccination certificates stated that they were given all 3 doses of diphtheria-containing vaccine, 83.6% had diphtheria antibodies and 92.7% had tetanus antibodies. Furthermore, despite a high prevalence of stunted and underweight children (53% and 25.8%, respectively), the low levels of anti-diphtheria antibodies were not correlated to the nutritional status.ConclusionsOur data highlight a significant deficit in both the vaccination coverage and diphtheria vaccine effectiveness within the Huaphan Province. Technical deficiencies in the methods of storage and distribution of vaccines as well as unreliability of vaccination cards are discussed. Several hypotheses are advanced to explain such a decline in immunity against diphtheria and recommendations are provided to prevent future outbreaks.

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Dataset Information

Stillbirth in Lao PDR: a healthcare provider perspective.

Background

Objective

Methods

Results

Conclusions

Publications

Stillbirth in Lao PDR: a healthcare provider perspective.

Similar Datasets

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