Improving Quality: Infant and Maternal Mortality in Angola and Nigeria

This essay critically analyzes methods for improving quality in infant and maternal mortality, focusing on Angola and Nigeria. It introduces relevant quality improvement methods, such as preventing birth defects, promoting safe sleep environments, and implementing infant screening programs. The essay provides a critical analysis of quality areas, including maternal supplementation, infection control, and intrapartum care, supported by research and literature. It also discusses governance structures, highlighting the role of clinical governance in healthcare organizations, and examines intervention programs like 'Safe Motherhood' aimed at reducing mortality rates. The essay emphasizes the need for stakeholder involvement and the delivery of quality care services to improve outcomes. The essay provides an overview of the factors affecting infant and maternal mortality and offers insight into the need for interventions to promote health and wellbeing.

Health governace and
economics
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Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
1)Relevant quality improvement methods are introduced and applied to infants and maternal
mortalitys................................................................................................................................3
2)Critical analysis of quality area using relevant research and literature...............................5
3)Governance structures.........................................................................................................6
4)Outcomes.............................................................................................................................7
CONCLUSION................................................................................................................................9
REFERENCES..............................................................................................................................10
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INTRODUCTION
Maternal mortality has been referred to the deaths of pregnant ladies while or during the
delivery or during the post pregnancy duration. This is irrespective of the place as well as the
time of the pregnancy which can be triggered from any type of cause associated to the pregnancy
or may be related to its management (Moucheraud and et.al., 2015). Infant’s mortality on the
other hand related to the death or less management of mother during the course of pregnancy
which ultimately leads to the death of infants under the age of 1. Angola and Nigeria has been
considered as the two countries with highest rate of infants and maternal deaths respectively.
The eassy will focus on the quality improvement methods of infants and mother during
pregnancy to reduce their mortality rate. Critical analysis of the quality area and governance
structure will be discussed. Different outcomes and impact of inequalities will also be evaluated
and interventions will be mentioned accordingly.
MAIN BODY
1)Relevant quality improvement methods are introduced and applied to infants and maternal
mortality
The rates of mortality in infants and maternal have been increasing day by day due to low
quality of life and factors like education, health status, economic conditions, literacy rate,
environment and society. The countries like Angola and Nigeria have largest number of deaths in
mothers and infants due to mental, physical, social and behavioural heath state. Some of the
improvement quality methods which has to be adopted for improving and maintaining the well
being of both mother and child so that they can live healthy life. One of the quality improvement
method may be preventing defects in the birth, as defects in birth are now a day’s major cause
of maternal and infant mortality all around the globe especially in Angola and Nigeria. There are
several kinds of defects in birth, and they might happen in all pregnancy. The are various things
a pregnant woman could do to reduce the peril of several birth defects, for instance getting
adequate folic acid before and in mid pregnancy to reduce neural defects in tube (Beaumont and
et.al., 2015).
As observed that by receiving preconception as well as prenatal care during
pregnancy, mother’s health, surroundings, and experiences effect how fetus grows and course of
pregnancy. By taking care of themselves before and in mid pregnancy, a mother can implement
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ways to minimize the child’s risk of various major reasons of infant and maternal mortality,
which includes defects in birth, preterm birth, birth low weight, firm pregnancy complications.
These steps to enhance the health a woman should not wait till the time of their pregnancy.
Achieving health weight, eating proper diet etc. all these steps can help a woman to reduce the
maternal mortality as well the risk of infant mortality at the time of pregnancy. By creating a
benign Environment for infant sleep it can lower SIDS which stands for Sudden Infant Death
Syndrome. SIDS can be explained as the quick, inexplicable demise of a newborn littler than age
of 1 year and which remains mysterious even after various deep investigation. SIDS is one of the
major causes of maternal and infant mortality all over the world. SIDS is a form of death under
the umbrella of reasons of demise called SUID. The SUID includes different sleep-related
reasons of infant and maternal death, such as infections, accidental suffocation, vehicle collisions
and other root causes. While there is decline in the SIDS rates in the past few years, other sleep-
related reasons of infant mortality are increasing. Unintended injuries are another reason of
infant death all over the world. There are conducts to reduce the peril of SIDS as well as various
sleep-related reasons for death of infant. For instance, always keeping a newborn on their back
for sleep as well as keeping newborn’s sleep zone free from soft items, crib bumpers are
essential conducts to minimize the newborn’s risk. The NICHD campaign explains various
methods that parents can minimize the peril of SIDS and different sleep-related reasons of infant
deaths in Angola and Nigeria.
The Exhausting Infant Screening to find concealed circumstances is an efficient
improvement methods for infant screening which can find various circumstances that cannot be
noticed at the period of birth, which can lead to grave disability or can also become the reason
for the demise if not properly taken care of. Newborns with such kind of conditions may look
completely healthy and usually come from background with no history of such condition (Evans,
Goldstein and Popova, 2015). In order to accomplish this screening, some blood is taken out of
infant’s heel and put that blood to a special kind of paper. The blood is then examined. If any
circumstances are found, proper treatment begins taken instantly. Since this program was
initiated in early 1960s, the program is able to save innumerable lives by providing early finding
and intercession and by refining the life of infant and their mother.
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2)Critical analysis of quality area using relevant research and literature
It has been observed that the main and leading reasons behind the mortality rate of infants
are mother complications during pregnancy, for instance, smoking habit of mother during the
course of pregnancy may lead to birth defects and cause quick new born death syndrome. The
maternal mortality occur mainly due to rigorous bleeding at the time of child birth. The deaths
may also be caused by the outcome of infection usually after delivery of baby or such action may
be resulted due to complications from the delivery which not only increase the number of deaths
in mothers but also severly affects the quality of life in infants (Quansah and et.al., 2015). The
child has been considered as the future of any country and the health evaluation and ritical
analysis of quality area must be adopted in efficient and effective manner to uplift the country as
well as the family and community.
The areas which need to critically analyse and evaluate are the maternal supplementation
during the pregnancy, which will affect the life of both mother as well as the baby. The
supplementation of calcium and zinc should be regulated carefully (Gülmezoglu and et.al.,
2016). The uptake of calcium should be initiated from 20 weeks of conception as it has been
observed that ingestion of calcium lower the risk of hypersensitive syndrome in pregnant lady.
Consumption of zinc decreses the threat of preterm birth. Overall balance of energy requirement
should be in adequate amount, around 25% total energy must be in form of protein has been
regareded as a necessary and essential method for preventing maternal under nutrition condition.
Another analysis area should be focus on maternal infection which has a negative consequence
on the perinatal outcomes and lowering mortality rate of both mother and baby efficiently.
Antenatal treatments involves in immunizing the pregnant lady with tetanus toxoid to eliminated
the death from neonatal tetanus by large percentage. The women having undiagnoised and
untreated syphilis have huge risk of still births, thus antenatal syphilis diagnosisis is required to
reduce infants deaths and neonatal mortality. For malaria prophylactic antimalarial drug can be
used as an effective method to improve the birth weight and deaths of neonatal. So as to lower
the intrauterine growth restriction (IUGR) which is one of the major cause of deaths and severe
morbidity, methods like counting fetal movement and antithrombotic agents have ben
established.
By counting the movements of foetus indicates its healthy nature, if the movements are reduced
then it may signify that the foetus may be compromised. The issue of protein and energy
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malnutrition as well as stumpy birth weight require improvements in maternal health and
prenatal care by encouraging breastfeeding and child growth and space analysis. The treatment
with heparin should be avoided, as it enhances the pregnancy complications. Antithrombotic
agents must be used to treat harmful blood clotting and significantly lowers the perinatal deaths
as well as infants birth weight. Intrapartum care must also be monitored and has been
considered as a critical area to evaluate and analyse. Labour supervision is required for
management clinically and reduce prior complications (Lorenz and et.al., 2016). The care must
include delivery of parenteral oxytocin, antibiotics for eclampsia. The skills and items for
manually removing placenta must be gathered around and ability to perform vaginal delivery
must be present with skilled and professional doctors. Such practices must be assured as still
births and infants mortality is being closely associated with difficult and troubled labour.
3)Governance structures
Governance structures are the frameworks that consist of some set legal policies and
standards for the management of an organisation in order to achieve target goals and objectives.
It is basically a structure that make leaders and supervisors of an organisation to improve their
operations and services. It plays a most crucial role in healthcare organisations so that the
treatments and other care services could be deliver properly to the patients and service users
(Nagaraja, 2016). Clinical governance in healthcare organisations help in maintenance and
improving public health and safety. There are no specific models to be followed in public health
sectors, as they attempt to develop their own models for acquiring its clinical objectives.
Winiseph care home is a healthcare organisation in Nigeria that supports and promote health of
individuals in order to improve overall health conditions in country. They basically provide set
programmes of some activities in order to promote health and social wellbeing of individuals
(Singh, 2017). Nigeria has a high occurrence of infant or maternal mortality due to lack of
education and poor health services. Thus, there is a great need in respective country to make
efforts for reducing infant and maternal mortality in order to increase overall health. Winiseph
care home develop some intervention programs for reducing the ratio of this particular health
issue by promoting health and aware individuals regarding the negative consequences of infant
mortality. A framework has been developed in the organisation that shows a structure for
organising and accessing information regarding initiatives that are need to be consider that could
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be implement in the organisation resulting in improved maternal care. Stakeholders of the
organisation are required to deliver best of their clinical practices on women that are in a period
of pregnancy so that there are less chances of deaths. Providing quality care services to the
women during pregnancy will reduce the chances of death of infants under the age of one year
(Leloup, 2017). They provide best quality of food and nutrition to the women within the
organisation that help the infant to develop and grow infants and keeping them healthy. The
programme deliver the information about each and every important aspects of pregnancy such as
physical exercises, food, care and many more. Reduce infant and mortality rates not only effect
baby and mother but also their families including whole community. It is the most leading cause
of death in Nigeria and interventions are need to be applied. A safe motherhood is a programme
which could be implemented in respective organisation. The main objective of such programmes
is to raise the awareness of consequences of poor maternal health and some actions to be
implemented for addressing this particular issue. It is not just a public health concern, but also a
human right and such efforts will help in to access safe pregnancy and infant births. The
programmes in the Winiseph care home deliver the information about risks factors, health
behaviours and negative consequences of poor care during pregnancy. The programme also
include some activities which creates a safe an healthy environment for the individuals and some
measures for preventing birth defects. They provide some important medications and other care
facilities to the women so that there are less chances of any risk factors that may arise. However,
the funds for such kinds of interventions are provided by government of the country weather
local or state. They provide financial support to such care homes so that there could be surplus
amount of resources and high educated care professionals that have skills and know clinical
practices for delivering during pregnancy.
The respective organisation has built some strategies and plans for achieving their target
objectives which is to reduce infant and maternal mortality in the public.
4)Outcomes
Reducing infant and maternal mortality in countries like Nigera and Angola are the major public
health issues and been increasing day by day. However, number of programmes has been
developed by the government and many healthcare organisations in order to regulate and address
the issues among individuals (Viens and et.al., 2019). Decreasing the rate of maternal mortality
in the country is important as it could result in extreme poverty within the country. Such
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programmes address inequalities for accessing to and quality of maternal, reproductive and new
born healthcare services. The outcome of these programmes include better health and a
decreased number of maternal health in women. The care which has been providing to the
mothers in various healthcare organisations has been improved and there is a improvement in
health conditions of both infant and mothers (Ado, 2016). Intervention of these program will
help the individuals to be aware about the negative impacts of maternal mortality. Defects in
births will e improved in the country and there will be less chances of risks that may be occur
during pregnancy.
There is less discrimination and inequality in the country by implementing these
programs for maternal mortality and infant mortality. The mothers will be treated equally
irrespective of their caste, religion, financial status etc. Number of infections and errors during
the whole period of pregnancy will be reduced and there is improvement in overall health
conditions of the countries as children and women consist of more than half of the population. A
high quality of parental care during pregnancy will result in improving mother’s health, and
health condition of the infant while their birth. Interventions for mothers during mid pregnancy
such as reducing defects in birth, birth low weight, firm pregnancy and complications will help
in to decrease the rate of maternal mortality as well as a better health of children. A healthy and
safe environment in the organisations will help the mothers to deliver infants safely with a less
chance of infections and other health conditions that could be arise.
There are number of programmes that does screening of health and overall body check-
up of women who are going through pregnancy. Screening will help in to know any sort of
defects or errors arising in the body that could be harmful for the infant. Health screenings of
infants will results in to know any diseases or disabilities that took place during delivery.
Number of trials has been done by the government as well as public health sectors within the
country like Nigeria and Angola in order to minimize the occurrence of infant as well as
maternal mortality. Such trials consist of measures to prevent premature birth and deaths of
women during pregnancy. Improvements like better sanitation skills has been said to be effective
in minimizing public health outbreaks and chances of disorders among children and mothers.
The efforts which were taken for improving financial status of women families helps in to reduce
mortality rates as families could be able to access o high quality of healthcare services for both
mother and infant (ALIAJ and MEKAJ, 2018). Other activities such as educational programs has
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proved to be spread awareness amongst individuals in both rural or urban areas which is a
effective strategy for reducing such kinds of major public health issues.
Current policies and standards of government focus on developing human resources such
as highly educated care professionals, strengthen health information system in the country,
delivery of high quality of services and many more results in low risks of infant and maternal
mortality. Government play a most crucial role in this subject by combining need for education,
nutrition as well as access to all sort of healthcare services need in the period of pregnancy.
CONCLUSION
From the above study, it can be concluded that health governance as well as economics
play a crucial role in order to meet requirements of major public health issues. In this study, a
major public issue which is maternal and infant mortality in many of the countries has been
focused. Reduce infant or maternal mortality will help in to enhance the overall health of the
country as well as reduce the chances of poverty. Governance frameworks and policies help the
healthcare sectors and organisation to deliver a high quality of services to the women going
through pregnancy and to provide proper nutrition to newly born infants. Quality improvement
methods has been discussed in order to minimize the rate of maternal and infant mortality. It
could be done through preventing birth defects and poor health conditions of both mother and
child. Critical analysis has been done o analysing the improvements in the quality area in the
countries that has high chances of maternal and infant mortality.
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REFERENCES
Books and journals
Ado, A.B., 2016. Corporate governance as a mechanism for measuring financial performance of
banks in Nigeria (Doctoral dissertation, Universiti Utara Malaysia).
ALIAJ, M.K. and MEKAJ, M.G., 2018. Legal Aspects of International Trade. ILIRIA
International Review. 8(2).
Beaumont, J and et.al., 2015. Infant mortality and isotopic complexity: New approaches
to stress, maternal health, and weaning. American Journal of Physical Anthropology. 157(3).
pp.441-457.
Evans, D.K., Goldstein, M. and Popova, A., 2015. Health-care worker mortality and the
legacy of the Ebola epidemic. The Lancet Global Health. 3(8). pp.e439-e440.
Gülmezoglu, A.M and et.al., 2016. Interventions to reduce maternal and newborn
morbidity and mortality.
Leloup, F., 2017. " Governance across European borders: conflict or cooperation?. In Conflict
and Cooperation at EU Borders.
Lorenz, J.M and et.al., 2016. Infant mortality in the United States. Journal of
Perinatology. 36(10). p.797.
Moucheraud, C and et.al., 2015. Consequences of maternal mortality on infant and child
survival: a 25-year longitudinal analysis in Butajira Ethiopia. Reproductive health. 12(1). p.S4.
Nagaraja, K., 2016. E-Governance in India: Issues and Challenges. IOSR Journal of Economics
and Finance. 7(5). pp.50-54.
Quansah, R and et.al., 2015. Association of arsenic with adverse pregnancy
outcomes/infant mortality: a systematic review and meta-analysis. Environmental health
perspectives. 123(5). pp.412-421.
Singh, A., 2017. Women empowerment their participation and challenges in Panchayati raj
institutions. International Journal of Advanced Research and Development. 2(5). pp.181-184.
Viens, A.M.,and et.al., 2019. Education, training, and experience in public health ethics and law
within the UK public health workforce. Journal of Public Health.
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