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Adaptation of the WHO maternal near miss tool for use in sub–Saharan Africa: an International Delphi study

Overview of attention for article published in BMC Pregnancy and Childbirth, December 2017
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (82nd percentile)
  • Above-average Attention Score compared to outputs of the same age and source (63rd percentile)

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Title
Adaptation of the WHO maternal near miss tool for use in sub–Saharan Africa: an International Delphi study
Published in
BMC Pregnancy and Childbirth, December 2017
DOI 10.1186/s12884-017-1640-x
Pubmed ID
Authors

Abera K. Tura, Jelle Stekelenburg, Sicco A. Scherjon, Joost Zwart, Thomas van den Akker, Jos van Roosmalen, Sanne J. Gordijn

Abstract

Assessments of maternal near miss (MNM) are increasingly used in addition to those of maternal mortality measures. The World Health Organization (WHO) has introduced an MNM tool in 2009, but this tool was previously found to be of limited applicability in several low-resource settings. The aim of this study was to identify adaptations to enhance applicability of the WHO MNM tool in sub-Saharan Africa. Using a Delphi consensus methodology, existing MNM tools were rated for applicability in sub-Saharan Africa over a series of three rounds. Maternal health experts from sub-Saharan Africa or with considerable knowledge of the context first rated importance of WHO MNM parameters using Likert scales, and were asked to suggest additional parameters. This was followed by two confirmation rounds. Parameters accepted by at least 70% of the panel members were accepted for use in the region. Of 58 experts who participated from study onset, 47 (81%) completed all three rounds. Out of the 25 WHO MNM parameters, all 11 clinical, four out of eight laboratory, and four out of six management-based parameters were accepted, while six parameters (PaO2/FiO2 < 200 mmHg, bilirubin >100 μmol/l or >6.0 mg/dl, pH <7.1, lactate >5 μmol/l, dialysis for acute renal failure and use of continuous vasoactive drugs) were deemed to not be applicable. An additional eight parameters (uterine rupture, sepsis/severe systemic infection, eclampsia, laparotomy other than caesarean section, pulmonary edema, severe malaria, severe complications of abortions and severe pre-eclampsia with ICU admission) were suggested for inclusion into an adapted sub-Saharan African MNM tool. All WHO clinical criteria were accepted for use in the region. Only few of the laboratory- and management based were rated applicable. This study brought forward important suggestions for adaptations in the WHO MNM criteria to enhance its applicability in sub-Saharan Africa and possibly other low-resource settings.

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The data shown below were collected from the profiles of 11 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 130 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 130 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 24 18%
Researcher 19 15%
Student > Postgraduate 8 6%
Student > Ph. D. Student 7 5%
Other 6 5%
Other 23 18%
Unknown 43 33%
Readers by discipline Count As %
Medicine and Dentistry 45 35%
Nursing and Health Professions 16 12%
Social Sciences 5 4%
Biochemistry, Genetics and Molecular Biology 4 3%
Immunology and Microbiology 3 2%
Other 12 9%
Unknown 45 35%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 10. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 October 2021.
All research outputs
#3,287,037
of 23,015,156 outputs
Outputs from BMC Pregnancy and Childbirth
#917
of 4,238 outputs
Outputs of similar age
#75,682
of 441,864 outputs
Outputs of similar age from BMC Pregnancy and Childbirth
#35
of 97 outputs
Altmetric has tracked 23,015,156 research outputs across all sources so far. Compared to these this one has done well and is in the 85th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,238 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.8. This one has done well, scoring higher than 78% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 441,864 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 82% of its contemporaries.
We're also able to compare this research output to 97 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 63% of its contemporaries.