Causes Of Maternal Mortality Rate Research Articles

АКУШЕРСКИЙ ГЕМОЛИТИКО-УРЕМИЧЕСКИЙ СИНДРОМ, АССОЦИИРОВАННЫЙ С БЕРЕМЕННОСТЬЮ, У ПАЦИЕНТКИ С ИНФЕКЦИЕЙ И МАССИВНЫМ КРОВОТЕЧЕНИЕМ: КЛИНИЧЕСКОЕ НАБЛЮДЕНИЕ

The study aims to present a clinical case of a rare pathology such as obstetric hemolytic uremic syndrome associated with infection during pregnancy, and complicated by massive bleeding, a critical obstetric condition, and a high risk of maternal mortality in a near-miss case. The study analyzes changes in causes of maternal mortality rate in the Russian Federation, including changes towards extragenital diseases; indirect causes and embolisms; preeclampsia, obstetric bleeding, and sepsis despite their decrease in the causes of maternal mortality rate; and such diseases as thrombotic microangiopathy, which is considered a probable life-threatening maternal condition and named a critical obstetric condition, that can be diagnosed in a highinformation laboratory with an instrumental basis. Thrombotic microangiopathy is attributed to many diseases, therefore, there are many unclear and controversial issues in diagnosing such a disease during pregnancy. Its clinical symptoms include hemolytic microangiopathic anemia, thrombocytopenia, thrombosis of the terminal arterioles and capillaries of the microvascular bed, and multiple organ dysfunction.

Implementasi Asuhan Pasca Keguguran di Wilayah Kerja Puskesmas Paringin Selatan Kabupaten Balangan

The background of this study is still high Maternal Mortality Rate (MMR), MMR is one indicator to see efforts to succeed in maternal health, mortality rates can occur during pregnancy, childbirth and postpartum. Miscarriage during pregnancy and incomprehensive post-miscarriage care is one of the causes of MMR. The purpose of this study was to find out how the implementation of post-miscarriage care in the working area of the South Paringin Health Center, Balangan Regency. This research method is descriptive quantitative, using secondary data derived from medical records, the population of this study is all post-miscarriage mothers from January 2021 to October 2022, the sample in this study uses total sampling techniques where all populations are sampled, namely 37 post-miscarriage mothers. The results showed that post-miscarriage care has not been said to be comprehensive because it still focuses on medical management and is only based on patient complaints.

Determinan Kejadian Hipertensi pada Ibu Hamil Di Puskesmas Purwokerto Utara II

The Maternal Mortality Rate (MMR) is an indicator to see the success of maternal health efforts. MMR in Banyumas Regency in 2019 was 38 per 100,000 live births and in 2020 it was 41.55 per 100,000 live births. The most common causes of MMR in Banyumas Regency are preeclampsia, bleeding during pregnancy, childbirth and the puerperium accompanied by complications from comorbidities. Maternal deaths usually occur because of the high cases of pregnant women with high risk. Factors that influence the incidence of preeclampsia can be interrelated and influence one another. Knowing the risk factors for hypertension in pregnancy is useful for the health care system for pregnant women to monitor risk groups from early pregnancy to the second trimester. The purpose of this study was to determine the determinants of the incidence of hypertension in pregnant women at the North Purwokerto II Health Center. The research design is a cross sectional study. Respondents in this study were pregnant women at the Purwokerto Utara 2 Public Health Center, Banyumas Regency. Data was taken in August - September 2022 using a questionnaire and direct blood pressure measurements. Samples were taken using total sampling technique with a total of 67 respondents. Statistical tests used univariate analysis (frequency distribution) and bivariate analysis using the fisher's exact formula (p <0.5). The results of this study were that there were no factors related to the incidence of hypertension in pregnant women at the Purwokerto Utara II Health Center with a p value > 0.05. There is no relationship between maternal age, gestational age, parity, occupation, education level, socioeconomic status, family history of hypertension, overweight and use of contraceptives with hypertension in pregnant women at the Purwokerto Utara II Health Center.

Kehamilan Lebih Dari Tiga Memiliki Pengaruh Besar Terjadinya Perdarahan Pasca Bersalin

Background: Based on data from the Public Health Office of Yogyakarta Special Province in 2014, the cause of Maternal Mortality Rate (MMR) in Yogyakarta was 40 cases. There were 12 cases of maternal death, especially in Sleman, and the causes of maternal death were due to hemorrhage. In Regional Public Hospital of Prambanan, the data presented that during January 2015- December 2017 the cases of hemorrhage were 71 patients. Methodes. The objective of this study was to determine the correlation between parity and the incidence of pasca bersalin hemorrhage in Regional Public Hospital of Prambanan. This study applied a case control analytic survey method with a retrospective time approach. The samples of the case group were 44 respondents, and the control group were 44 respondents in January 2015 - December 2017 with total sampling technique for the case group and purposive sampling for the control group. The instruments used were the observation sheets and the data analysis used Chi square Result: of Chi square test in the case group of maternal parity at risk of experiencing hemorrhage was as much as 32%, and in the control group of maternal parity who were not at risk of experiencing pasca bersalin hemorrhage was as much as 20%. The p value was 0.001, and the Odds Ratio value (OR) was 4.173. Conclusion : There was a correlation between parity and the incidence of hemorrhage. The high risk maternal parity is 4 times more at risk of experiencing the incidence of pasca bersalin hemorrhage than the maternal parity which is not at risk. It is expected that midwives can improve

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KETIDAKPATUHAN KUNJUNGAN KEHAMILAN K1-K4 PADA IBU HAMIL DI BPM BIDAN MARI SENTONO, PEGADUNGAN, KALIDERES TAHUN 2020

One of the causes of Maternal Mortality Rate (MMR) is complications in pregnancy and childbirth. Complications of pregnancy and childbirth can be prevented by regular antenatal care (ANC) examinations. ANC is a visit by pregnant women with health workers to get pregnancy services in accordance with established standards. Of these 114 pregnant women patients, there were patients who were not compliant (having visits less than 4 times) as many as 89 (78%) patients while the data on the coverage of antenatal care visits in DKI Jakarta in 2019 was 88.54%, this was due to a lack of knowledge about pregnancy visits, parity, and mileage. The purpose of this study was to determine the factors associated with non-adherence to pregnancy visits K1-K4 in pregnant women. This research is a quantitative research with a cross sectional design. This research was conducted in January – August 2021. The population in this study were all pregnant women at BPM Midwife Mari Sentono in 2021 as many as 114 people in January – April. The sample in this study was 75 medical records of pregnant women with simple random sampling method. Data analysis was carried out univariate and bivariate with Chi Square test (α = 0.05) and calculate the Prevalence Ratio (PR) value. The results of the Chi Square test are age (p-value = 0.962, PR = 1.085), education (p-value = 0.027, PR = 0.487), occupation (p-value = 1,000, PR = 1,000), parity (p-value = 1,000). value = 0.037, PR = 1.975), and distance traveled (p-value = 0.024, PR = 2,000), the conclusion is that there is a relationship between education, parity and distance traveled with non-compliance with K1-K4 visits to pregnant women at BPM Midwife Mari Sentono. Suggestions for the BPM are expected to be used as input to develop a special program in increasing the coverage of ANC visits during the pandemic in order to minimize the incidence of maternal and infant mortality.

No Correlation Between Anemia in Third Trimester Pregnant Women and Preeclampsia/Eclampsia inDr. Seotomo Hospital Surabaya

Based on the latest survey data, Indonesia's Maternal Mortality Rate (MMR) is 305/100,000 live births. One of the the most common cause of Maternal Mortality Rate is Preeclampsia. Globally, preeclampsia is still a problem associated with MMR. 10% of pregnant women worldwide experience preeclampsia, and it is the cause of 76,000 maternal deaths and 500,000 infant deaths each year. According to World Health Organization (WHO), it is reported that the global prevalence of eclampsia is 0.3%, causes of maternal death ranged from 1.5 percent to 25 percent. In addition to other vascular disorder, anemia considered high with prevalence of 49.8% in Indonesia. There have not been many significant studies on the effect of anemia with the incidence of preeclampsia and eclampsia. This study aims to explore the correlation between risk factor of anemia and the incidence of preeclampsia and eclampsia in Dr. Soetomo Hospital Surabaya, Indonesia. This research was carried out with cross-sectional studies with total samples 0f 141 pregnant woman in Dr. Soetomo Hospital Surabaya, Indonesia. Age characteristics taken are 18-35 years old. Primigravida (33.33%), multigravida (66.70%). Hb < 11 g/dL (40.40%), > 11 g/dL (59.60%). Patients with anemia and preeclampsia/eclampsia (30.60%), without preeclampsia/eclampsia (69.40%). Patients without anemia with preeclampsia (52.20%), without preeclampsia/eclampsia (47.80%). The results of Chi Square analysis found no significant correlation between anemia with the prevalence of preeclampsia (p=0.062) at Dr. Soetomo Hospital, Surabaya, Indonesia.

Teknik Relaksasi dengan Alat Musik Tradisional Mandar Menurunkan Skala Nyeri pada Ibu Bersalin Kala I Fase Aktif

The direct causes of maternal mortality rate are bleeding, eclampsia, abortion, infection, and prolonged labor. Maternal mortality rate can be minimized by safe, clean help, and prevent complications. Labor is a process that begins with uterine contractions causing progressive dilation of the cervix, birth of a baby, and labor of placenta and it is a natural process. This study aims to see the effectiveness of instrumental music relaxation techniques using traditional musical instruments on the labor process of inpartu mothers when phase I was active at Community Health Center in Tampa Padang, Mamuju. This study is an experimental study with a pre-experimental conception and use one group pretest-posttest conception with the population of maternal mothers at Tampa Padang Community Health Centre. The samples are pregnant women who entered the delivery room with inpartu diagnosis of the first stage/phase is active or the opening stage. The sampling technique was consecutive sampling which could be done by 31 people. The data then being analyzed with univariable analysis and bivariable analysis using the Wilcoxon Test with a significance level of 0.05 to see the interface relationship with the decrease in pain scale. The results showed a relationship in reducing pain scale of mothers who were given musical intervention with Mandar traditional musical instruments where p = 0.000. The conclusion of this study shows that by applying instrumental music relaxation techniques with traditional Mandar musical instruments, mothers can adjust to pain during labor so that it can reduce the pain scale in mothers in labor when phase 1 is active.

PENGETAHUAN IBU NIFAS TENTANG KUNJUNGAN ULANG MASA NIFAS DI PUSKESMAS TEPUS 1 KABUPATEN GUNUNGKIDUL

Background: The causes of Maternal Mortality Rate (MMR) in Indonesia are bleeding (30.3%), hypertensive disorder during pregnancy (27.1%), infection (7.3%), obstructed (1.8%) and abortion (1.6%). Bleeding occurs in the postpartum period which is started after delivering placenta and ended when the the womb organs recovered as before pregnant. The length of postpartum period is about 6 weeks. During postpartum period, there are several re-visit to heath provider such as; KF 1 (first postpartum visit) is a visit on 6 hours to day 3rd after delivering, KF 2 (Second postpartum visit) is a visit on day 4th to 28th after delivering, and KF 3 (third postpartum visit) is a visit on day 29th-42nd after delivering.&#x0D; Objective: This study aimed to describe the knowledge level of postpartum mother about visitation during childbirth.&#x0D; Method: This study was a descriptive quantitative research with cross sectional design. The number of sample was 30 respondents. The data were taken using primary data and questionnaires.&#x0D; Result: The postpartum mother who do postpartum visits in Puskesmas Tepus 1 Gunung in the age of 20-35 years category was 19 respondents (63.3%). A number of 13 respondents (43.3%) had secondary school, 19 respondents (63.3%) were housewife and 18 respondents (60%) had 2-3 children. The result of postpartum revisit showed that 13 respondents (43.3%) made KF1, 12 respondents (40%) made KF 2, and 11 respondents (36.7%) made KF 3.&#x0D; Conclusion: The knowledge level of postpartum revisit in Puskesmas Tepus 1 Gunung was mostly in adequate category.&#x0D; Key word: Postpartum Mother Knowledge, Postpartum Visits

CAN WE REDUCE MATERNAL MORTALITY

Objective: The objective of this study is to find out the maternal mortality ratein our setup and found the preventable causes of maternal mortality rate. Design: Descriptivestudy. Place and duration of study: In obstetric ward of Liaquat university hospital Hyderabadfrom 10th Feb 2011 to 10th Jan 2014. Patients and Methods: All the women who were died dueto pregnancy complications were included in the study while women who were not died due topregnancy complications and maternal deaths due to accidental or incidental causes duringpregnancy were excluded from the study. Details of patient’s history especially age, parity,socioeconomic condition, reason of death, antenatal status, and distance from hospital wererecorded on predesigned proforma. Results: Total 48563 deliveries were conducted during thestudy period. Out of these, 103 women died, so the maternal mortality rate was 212.09/ 100,000live birth. Majority of women i.e. 43(41.74%) died; belong from age group of 31-40 years.Majority of women i.e. 78(75.72%) belonged to poor socioeconomic group and 83(80.58%)women had not received antenatal care. Most common cause of maternal mortality in thisstudy was hypertensive disorder which was seen in 43(41.74%) followed by APH in 39(37.86%)and PPH seen in 6(5.82%) patients .The most common cause of delay in seeking health carefacility was lack of transport reported by 43(41.74%) patients and familial taboos reported by36(34.95%) patients. Conclusions: Most important cause of maternal mortality in our studywas hypertensive disorders, APH and PPH. Maternal mortality was highest in advancing age,increased parity and in unbooked patients.

PENURUNAN TINGKAT STRES IBU HAMIL DENGAN TERAPI MUSIK DAN AROMATHERAPY PADA KELAS IBU HAMIL

Preeclampsia is one of the causes of the high maternal mortality rate (MMR) in Indonesia. In Banyumas District, preeclampsia is the highest cause of MMR in January-June 2018 period. One of the risk factors of preeclampsia is the stress level in pregnancy. Prolonged levels of stress can lead to psychological changes in increased levels of adrenal and cortisol hormones. Non-pharmacological treatment techniques that can be used are music therapy and aromatherapy. The purpose of this study was to determine the effect of the addition of music and aromatherapy therapy on pregnancy class on the stress level of pregnant women. This research is a miniriset with the type of pre-experimental research using one group pretest posttest design. A sample of 20 pregnant women who attended pregnancy class. Measurement of stress levels was carried out before and after the intervention using the Perseived Stress Scale (PSS). The mean level stress before the intervention 18.60 with minimum value 12 and maximum value 27. Meanwhile, the mean level stress after intervention 18.30 with minimum value 11 and maximum value 27. There was decrease in stress levels 0.30. Based on the results of the study, it is expected that the increase in pregnancy class is accompanied by the addition of non-pharmacological therapies to overcome psychological problems in pregnant women such as music therapy and aromatherapy.

HUBUNGAN USIA PARITAS DAN JARAK KEHAMILAN DENGAN KEJADIAN ANEMIA SELAMA KEHAMILAN DI KLINIK HANNA KASIH MEDAN

Anemia in pregnancy is one of the causes of Maternal Mortality Rate (MMR) in developing countries. The main causes of maternal death include postpartum haemorrhage and placenta previa from deficiency anemia. In Indonesia, nutritional anemia is one of the main nutritional problems. Some predisposing factors that are thought to be closely related to the incidence of anemia in pregnant women are age, parity and distance of pregnancy. The aim of the study was to determine the relationship between age, parity and distance of pregnancy with the incidence of anemia during pregnancy. Samples were all pregnant women who were anemic during the study at the Hanna Kasih Medan Clinic in the January-March 2015 period, which amounted to 70 people. Data collection techniques with documentation. Analysis method using Chi-Square test. Conclusion there is a correlation between age (p = 0.000), parity (p = 0.000), and pregnancy distance (p = 0.004), with the incidence of anemia during pregnancy at the Hanna Kasih Clinic with the highest frequency is 47.1% mild anemia, age 20- 35 years 52.9%, multi gravida parity 34.3% and gestational distance &lt;2 years 77.1%.

KEJADIAN KEGUGURAN DITINJAU DARI UMUR IBU DI BPS ITA ARIANI WONOAYU SIDOARJO

The incidence of Abortion in terms of the maternal age in The Private Midwife Clinic of Ita Ariani Wonoayu Sidoarjo. Maternal Mortality Rate in Indonesia is still high about 206 over 100.000 life births. Abortion is one of the cause of maternal mortality rate. And pregnant mother who had age ( &lt; 20 and &gt; 35 tahun years old) is more get abortion. The purpose of this research is to analyze the correlation between maternal age with the occurance of abortion in The Private Midwife Clinic of Ita Ariani Wonoayu Sidoarjo. Design of this research is observational analytic using cross sectional method. Population of this research is 15 pregnant mothers with pregnancy age less than 20 weeks. Sample of this research as many as 14 people with simple random sampling technique. The independent variable is maternal age and the dependent variable is occurance of abortion. The data is collected from medical record and analyzed by using Chi – Square test. Result of this research show that most of respondents are pregnant mother who had low risk age (20 – 35 years old) as many as 8 people (57,1%) and pregnant mother who got abortion as many as 5 people (35,7%). Based from Chi–Square test show that P = 0,001 &lt; α = 0,05 and it is mean that there is correlation between mother age with the occurance of abortion. The conclusion of this research is mother age is one of the cause of abortion. Pregnant mother who had younger age (&lt; 20 years old) and older age (&gt; 35 years old), the probability of abortion is higher so pregnant mother must do ANC regularly.

Pengaruh Usia Ibu Hamil Terhadap Kejadian Placenta Previa Di RSUP Soeradji Tirtonegoro

Abstract : Maternal Age, Placenta Previa. Maternal Mortality Rate (MMR), is one of State Health Development Indicators. Indonesia MMR in the first level in Asean. Bleeding is the cause of MMR,placenta Previa is cause of bleeding, the incidence of placenta previa is 0.3-0.5% of all births, the risk of placenta previa associated with age of the women during pregnancy. Incidence increased as follows : 12-19 years - 1%, 20-29 years - 0.33%, 30-39 years - 1%, above 40 years - 2%. Incidenceof placenta previa in Soeradji Tirtonegoro HospitalKlaten in 2010 there were 122 cases. Thestudyused the Ex Post Facto, the population in this study is the maternal with plecentaprevia, the sample used a total sample of 122 maternal with placenta previa in 2010. Devendent variable in this study is placenta previa,independt variable is the maternal age, the studyin Dr Soeradji Tirtonegoro Hospital Klaten. Analysis used the linear regression.The effect of maternal age on the incidence of plcentsprevisis significantp = 0.000 (p&lt;0.05), 87.20% incidence of placenta previa is influenced by maternal age and the effect is very strong r = 0.938. Each additional 1 year of maternal age increases the incidence of placenta previa 1,332 cases

Effect of Maternal Education, Family Income, Mother-Midwife Interface, and the Incidence of Iron Deficiency Anemia in Pemalang, Central Java

Background : Maternal mortality rate was 359 per 100,000 live birth in Indonesia in 2012. An indirect cause of maternal mortality rate is anemia. This study aimed to investigate effect of maternal education, family income, mother-midwife interface, on the incidence of iron deficiency anemia in Pemalang, Central Java. Subje cts and Method : This was an analytical observational with case control design. This study was conducted at Purwoharjo, Rowosari, and Petarukan health centers, Pemalang, Central Java. This study was carried out from March 2 to 27, 2016. A total of 146 pregnant women from the three health centers were selected for this study by fixed disease sampling . This study consisted of pregnant mothers with iron deficiency anemia (cases) and those without iron deficiency anemia (controls) with equal share. The dependent variable was iron deficiency anemia, which was measured by Sahli method. The independent variables were maternal education, family income, and mother-midwife interface. These variables were measured by a set of questionnaire. The data were analyzed by path analysis. Results : Better knowledge (b= -1.26; p=0.002), positive attitude (b= -1.01; p=0.019), stronger purchasing power (b= -1.16; p=0.004) had direct effects on reduced risk of iron deficiency anemia, and they were statistically significant. There were positive effects of higher income on stronger purchasing power (b=0.63; p=<0.001), mother-midwife interface on better knowledge (b=0.19; p=0.021), mother-midwife interface on positive attitude (b=0.21; p=0.023), and higher education on better knowledge (b=0.21; p=0.035). Conclusion : Better knowledge, positive attitude, stronger purchasing power, have direct effects on reduced risk of iron deficiency anemia. Higher income has indirect effect on reduced risk of iron deficiency anemia via stronger purchasing power. Mother-midwife interface has indirect effect on reduced risk of iron deficiency anemia either via better knowledge or positive attitude. It is suggested that pregnant mothers increase their interaction with midwives so that they are able to detect sign and symptom of anemia and to take necessary preventive action. Keywords: iron deficiency anemia, pregnant mother, mother-midwife interface Correspondence : Ade Kurniati. Masters Program in Public Health, Sebelas Maret University, Surakarta Journal of Maternal of Child Health (2026), 1(4): 220-229 https://doi.org/10.26911/thejmch.2016.01.04.03

Association Between Pregnant Woman Class and Pregnancy Complication in Tegal District, Central Java

Background : Maternal mortality amounted to 33 cases in Tegal, Central Java, in 2015. The leading cause of maternal mortality rate in Indonesia was obstetric complication, i.e 46.8%. Pregnancy complication may be affected by maternal age, parity, education, and maternal employment status. Various efforts have been implemented by the government to reduce maternal mortality rate, including pregnant woman class. The objective of the pregnant mother class is to increase maternal knowledge in risk factor detection and to increase their willingness to use antenatal care. This study aimed to estimate the association between pregnant woman class and pregnancy complication, while controlling for confounding factors. Subje cts and Method: This was an analytical observational with case control design. This study was conducted at Pagerbarang, Pangkah and Dukuhwaru Health Centers, Tegal, Central Java. A total of 90 study subjects, consisting of 30 laboring women with complication and 60 without complication. The dependent variable was pregnancy complication. The independent variables were maternal age, parity, education, employment status, and participation in pregnant woman class. The data were collected by a set of questionnaire. The data on pregnancy complication was obtained from the obstetric record at the health center. The data were analyzed by multiple logistic regresion. Results : Parity ≥3 (OR = 3.47; CI 95% = 0.95 to 12.69; p=0.060) and maternal education <senior high school (OR= 8.58; CI 95% = 1.7 to 43.33; p= 0.009) increased the risk of pregnancy complication. Maternal age 20 to 35 years (OR= 0.26; CI 95% = 0.08 to 0.81; p=0.020), employed mother (OR= 0.21; CI 95% = 0.06 to 0.71; p = 0.012), and participation in pregnant woman class (OR =0.35; CI 95% = 0.12 to 1.05; p = 0.061), decreased the risk of pregnancy complication. Conclusion : Participation in pregnant woman class is associated with decreased risk of pregnancy complication. Parity ≥3 and maternal education <senior high school are associated with increased risk of pregnancy complication. Maternal age 20 to 35 years and employed mother are associated with decreased risk of pregnancy complication. It is suggested that pregnant women plan their pregnancy in order to prevent pregnancy complication. Keywords : pregnant woman class, pregnancy complication. Correspondence: Siti Maryani. Academy of Midwifery Siti Fatimah, Slawi, Central Java. Mobile: 085741950488. Journal of Maternal and Child Health (2016), 1(4): 214-219 https://doi.org/10.26911/thejmch.2016.01.04.02

Towards 2015: post‐partum haemorrhage in sub‐Saharan Africa still on the rise

To review literature from 1996-2012 relating to factors associating with the persistent maternal mortality rate (MMR) caused by post-partum haemorrhage (PPH) in sub-Saharan Africa. One woman dies every seven minutes, at the same time, one-quarter of all maternal death worldwide is being caused by PPH. The aim of United Nations Fifth Millennium Development Goal 5 is to lower MMR by three quarters between 1990-2015. Narrative literature review. Study articles from 1996-2012 were searched in electronic databases MEDLINE, Cochrane, PubMED, Google's scholar and manual searches. Combinations of the following search words were used: post-partum haemorrhage/bleeding, sub-Saharan Africa/rural areas, antenatal/obstetric care/maternal mortality/skilled care at birth/maternity care/health survey. 125 article abstracts were read, and 50 full articles used in this review. Every day about 800 women died due to birth complications in 2010: of the 800 maternal deaths worldwide, 440 occurred in sub-Saharan Africa with PPH being the main cause. Common causes of PPH are related to failure of the healthcare system, inaccurate estimation of blood loss after delivery and lack of skills to prevent and manage PPH. Special attention is needed with emphasis on regular attendance of antenatal clinic, proper information concerning pregnancy and delivery, skills to accurate estimate blood loss, and prevention and management of PPH. PPH is the leading cause of MMR in areas where essential care and skilled health attendants are limited. Basic Emergency Obstetric Care and arrangements for timely referral to the big hospital with facilities must be practiced everywhere. This review may help to remind health workers and the government that maternal mortality due to PPH is still higher and more interventions are needed.