Improving Health Systems Key To Reducing C-Section Deaths


South African obstetrician and gynaecologist Salome Maswime has found that the key to cut deaths from C-section complications like bleeding may be to reduce health system deficiencies.

Maswime, who is Full Professor and Head of Global Surgery at the University of Cape Town (UCT), South Africa says she initially focused on obstetric surgery, but this led to an interest in perinatal outcomes, and now access to neonatal surgery.

“I initially hypothesized that bleeding that occurred during a C- section could be resolved through new surgical techniques, or by strengthening surgical training programs, but instead found that health system deficiencies were the underlying cause,” she says.

In her 2019 paper “Maternal and neonatal outcomes after caesarean delivery in the African Surgical Outcomes Study: a 7-day prospective observational cohort study,” published in the The Lancet Global Health Maswime and a large number of collaborators in South Africa found African women are 50 times more likely to die from Cesarean complications than women in high income countries.

“This further affirmed that the state of the health system influences and determines surgical outcomes,” she says.

Maswime says she has a particular interest is in access to surgical care and corrective interventions, like in babies born with congenital abnormalities, and understanding the proportion of those who were diagnosed during pregnancy, versus those who were only diagnosed during and after birth.

“This also led to a partnership with Operation Smile, on research related to children with cleft lip and palate,” she says.

Maswime grew up in Limpopo province, South Africa, studying at the University of KwaZulu Natal in Durban, specializing at Wits University and then doing her my PhD in Obstetrics and Gynaecology.

She went on to do postdoctoral studies at the Harvard Medical School and Massachusetts General Hospital, with an interest in Global Health and Placental Science.

“Africans have often been the last to benefit from advances in science,” she says, “Its important that we set our own research agenda and lead our own research programmes and projects.”

Maswime says that those in the Global South are most affected by the challenges they face, but can also find solutions that are relevant and appropriate for that context.

“In our Global Surgery Division, we say we are finding local solutions to a global challenge,” she says.

Another researcher from the Global South working on the health of mothers and kids is Colombian Ana Palacios.

MORE FROM FORBESHow Eggs Can Help Kids Grow Up Healthier In Honduras

Palacios is working on a clinical trial with a community in Honduras to find out whether giving eggs to kids between the age of 6-24 months will help them in terms of growth, food security, and dietary diversity.



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