Argentina: risk factors and maternal mortality in La Matanza, Province of Buenos Aires, 1990.

S Szmoisz, S E Vuegen, A S Plaza, R Barracchini, S Checa, A Derlindati, D A Espinola, E C Rúgolo
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Abstract

An evaluation of the health services infrastructure of the La Matanza part of Buenos Aires in 1990 was carried out in addition to an evaluation of maternal mortality case studies. This procedure allowed for an assessment of factors related to the performance of health services and the health behaviour of women which, concomitantly, led to maternal deaths. Approximately 50% of maternal deaths went unreported in La Matanza on the basis of record checks performed in the institutions, hence the maternal mortality was twice as high as officially indicated for 1990. Flaws in the proper clinical diagnosis of the causes of deaths were detected and a higher degree of precision was called for. In the case of women who came from the poorest section of La Matanza, most deaths were due to complications related to abortion (either self-induced or non-professionally induced). Most of the maternal deaths could have been avoided. The sociological enquiry revealed conflicting social pressures which led the women onto the path of maternal death. The men were found not to be involved in the health issues arising from pregnancy and delivery, and the reproductive process was seen to lie exclusively in the women's domain. The services were not prepared to cater for the needs of poor women, and the inadequacy of the existing system to reach the women in need was well documented. Detection of women at risk was lacking in most establishments and, with the exception of one hospital, referral procedures did not exist. At the municipal level the absence of a policy for maternal and child health was noted.(ABSTRACT TRUNCATED AT 250 WORDS)

阿根廷:1990年布宜诺斯艾利斯省拉马坦扎的危险因素和产妇死亡率。
除了对孕产妇死亡率个案研究进行评估外,还于1990年对布宜诺斯艾利斯拉马坦扎地区的保健服务基础设施进行了评估。这一程序允许评估与保健服务的绩效和妇女的保健行为有关的因素,这些因素同时导致产妇死亡。根据在各机构进行的记录检查,在拉马坦扎约有50%的产妇死亡没有报告,因此1990年的产妇死亡率是官方数字的两倍。发现了对死亡原因的正确临床诊断存在缺陷,并要求更高程度的准确性。就来自拉马坦扎最贫穷地区的妇女而言,大多数死亡是由于与堕胎有关的并发症(自行流产或非专业流产)。大多数产妇死亡本来是可以避免的。社会学调查揭示了导致妇女走上产妇死亡道路的相互矛盾的社会压力。调查发现,男子不参与因怀孕和分娩而产生的健康问题,生殖过程被视为完全由妇女负责。这些服务没有准备好满足贫穷妇女的需要,现有制度在帮助有需要的妇女方面的不足是有据可查的。大多数机构都没有发现有危险的妇女,除了一家医院外,没有转诊程序。委员会指出,在市一级,缺乏妇幼保健政策。(摘要删节250字)
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