Introduction
Maternal and children mortality has become a major issue in many countries as the number of deaths have increased. Maternal death or maternal mortality is death of women during pregnancy or after pregnancy. In 2000, the United Nations estimated the global maternal mortality to be 529,000. The rate of maternal deaths in rural areas is high compared to the rate of maternal rate in urban areas. For instance, the rate of maternal rate in Vietnam is high. There are many causes of maternal deaths in the world. First, lack of proper antenatal care and nutrition has increased the maternal mortality and children mortality.
Maternal mortality and children mortality are preventable through medical practices and nutrition. Most countries have established measures to prevent maternal mortality and children mortality. For instance, the governments have made ante-natal care available to mothers in the rural areas so as to reduce deaths. Also, the governments have established nutrition programs to prevent maternal deaths. This paper analyzes whether ante natal care and nutrition program can be used to reduce maternal deaths and infant deaths.
Objectives of the proposal
The proposal is aimed at determining if provision of ante natal care and nutrition programs will help reduce the rate of maternal and children mortality in rural areas of Vietnam (De Brouwere, Tonglet &Van Lerberghe, 1998).
Research problem
Martenal mortality and children mortality have become a major issue in developed and developing countries. This is because of lack of proper nutrition and ante natal care. Most women and children in rural areas are not able to access ante natal care because of various reasons. First, women in rural areas have no enough money to access ante natal care .This makes it difficulty to get proper care before delivery. Also, lack of access to health care service has made it difficulty for the women to get ante natal care at the right time. In addition, the women are not able to get good nutrition. This has led to increase in maternal deaths and children mortality in Vietnam (De Brouwere, Tonglet &Van Lerberghe, 1998).
Literature review
The main causes of maternal death are bacterial infections and various types of gestation hypertension. For example, pre-eclampsia and HELLP syndrome have increased the rate of maternal mortality in many countries. Obstetrical hemorrhage, ectopic pregnancy and child bed fever cause maternal mortality. Other causes include amniotic fluid embolism, rupturing of the uterine and complications during birth. Unsanitary abortions have also led to maternal deaths in many countries. Severe bleeding or hemorrhage account for 25% of all the maternal deaths in the world. This is according to a report released by World Heath Organization, UNICEF,UNFPA in 2004 (WHO, UNICEF &UNFPA, 2004).In addition, the report showed that infections account for 13 % of the maternal deaths and children mortality.
Also, unsafe abortions and obstructed labor account for 13% and 8% of maternal deaths in developed and under developed countries. The report indicated that eclampsia accounts for 12% of maternal deaths and other direct causes and indirect causes make 8% and 20% respectively. In this case indirect causes include disease like malaria, anemia and HIV/AIDS and cardiovascular diseases. The diseases complicate the mothers pregnancy and, hence result to death of the mother and the unborn child. The report showed that 45% of postpartum death occur within twenty four hours.Developing countries experience high maternal deaths and children mortality than developed countries. 90% of maternal death occur mostly in developing countries and the other percentage occurs in developed countries (WHO, UNICEF &UNFPA, 2004).
Maternal mortality in Vietnam is high. The maternal mortality rate is 165/ 100,000 live births. This is according to statistics released in 2004 by UNICEF. The report showed that mortality rate among children aged 5 years was 39/100,000 live births In addition, UNICEF argued that over 7 women in Vietnam die from pregnancy and child birth every day. Also, 82 new born babies die prematurely every day (WHO, UNICEF &UNFPA, 2004). The maternal death rates vary from one region to another. For example, the highest maternal mortality rate occur in the mountainous area, rural areas and among ethnically minority populations. The report indicated that maternal mortality rate is almost ten times more higher in CAO bang province than in BInh Duong province in Vietnam. The maternal rate in Cao Bang province was 411 per 100,000 in 2004 and the maternal rate in Binh Duong province was 45 per 100,000 in 2004.
The infant mortality rate are high in ethnic minorities groups than for KInh majority. For instance, the Gia-rai minorities experience 69 deaths per 100,000 live births. De Brouwere, Tonglet and Van Lerberghe in their work argue that there are various reasons why the maternal rate and children mortality is high among ethnic minorities and women in Vietnam. First, lack of proper nutrition among the ethnic minorities and women in general has led to high maternal and child mortality. Most women rural areas in Vietnam are not able to afford a balanced diet during pregnancy. This is because the minority women and other women have no enough income.
Majority of the women depend on casual jobs and hence they get low incomes This makes it difficulty for the women to eat a balanced diet and take care of young children. Additionally, lack of enough income makes it difficulty for the women to access ante natal care. Most women working on casual jobs do not have health insurance covers. This is because the employers are not able to provide them with health insurance covers. This has made it hard for minority groups and women in general in Vietnam to get health care services (De Brouwere, Tonglet &Van Lerberghe, 1998).
On the other hand, women from rich families and major groups are able to get health care services. The women get quality ante natal cared. This has reduced the maternal rate and children mortality among rich people and major groups. Also, they are able to eat balanced diet. Hence, the researchers argue that social economic factors are the main causes of high maternal rate and children mortality in Vietnam. This is because they affect the kind of diet pregnant women feed and also access to medical services. Socioeconomic factors limit the proper eating habits and quality of medical services in the community (Villar & Bergsjo, 1997).
Moreover, Villar and Bergsjo argue that lack of access to health care services and quality care has led to high maternal rate and children mortality in Vietnam (Villar & Bergsjo, 1997). The researchers argue that anted natal care and nutrition programs can help reduce the maternal mortality rate and children mortality rate in rural areas. Ante natal care refers to care given to pregnant women before birth. Hospitals provide different services to pregnant women under ante natal care.
For instance, the hospitals provide education to pregnant women. Also, the hospitals provide counseling, screening and treatment for various infections. The hospitals help monitor the progress of pregnant women and the wellbeing of the mother and the unborn child. However, the hospitals do not know the type of care that is effective for pregnant women. Also, the hospitals do not know the quantity of care that will be effective for pregnant mothers and the unborn children.
The World health organization, Simon,DI Mario and Vittorio Basevi carried out research to determine the effectiveness of antennal care in reducing maternal rate and children mortality (World health organization, Mario & Vittorio Basevi, 2005). In their article titled,” what if the effectiveness of antenatal care?(supplement)”, the authors identified various interventions that can be used to prevent maternal rate and children mortality.
For example, the authors argued that life style changes helped improve the life of pregnant women and unborn children. The authors argued that providing the right diet and supplements can help reduce the rate of maternal deaths and infant deaths. Pregnant mothers are supposed to take a balanced diet. The diet should include proteins, energy giving foods and vitamin. The different groups of food play different roles in the body of pregnant women.
For example, energy giving foods provide pregnant mothers with enough energy to carry out their daily activities. Also, proteins help in the growth of the feotus. This helps prevent preterm births and children are born having the normal weight. In addition, vitamins prevent the pregnant mothers and their children from contracting diseases. The researchers argue that balanced diet and supplements helps improve the growth of the fetus and ,hence reduce the risk of low birth weight children and deaths of children during birth and after birth. Though proteins are important in reducing maternal and children mortality, high protein supplements alone is not important. This is because high protein supplement is linked with increased risk of small for b gestation age (World health organization, Mario & Vittorio Basevi, 2005).
On the other hand, women who azure obese or overweight are supposed to reduce the amount of proteins and calories they take. This will help reduce the risk of contracting various diseases like obesity, heart diseases etc. Though, reducing the rate of calories and proteins overweight women take has a lot of benefits, it has more harm to the fetus than benefits. It limits the fetus from growing healthily. This in turn leads to low birth weights and death of preterm and premature babies. So, pregnant women should be provided with the proper diet so as to prevent the mothers and children from contracting diseases (World health organization, Mario & Vittorio Basevi, 2005).
Additionally, the researchers claim that providing pregnant women with dietary supplements can held reduce maternal and children mortality. For example, pregnant women can be provided with folic acid before conception and during gestation. Folic acid reduces the rate of complications among pregnant women. The pregnant women should be provided with vitamin and calcium supplements. Calcium supplement helps reduce the risk of high blood pressure during pregnancy. This is mostly among women who are at high risk of having high blood pressure and women in communities that have low calculi intake (Villar & Bergsjo, 1997).
Most organizations like WHO and researchers have associated maternal mortality and children mortality with anemia. Pregnant women should be provided with iron supplement as it helps reduce the frisk of low birth weight. This helps reduce the rate of children mortality that results from low birth weights. Moreover, iron supplements help prevent low blood count during delivery and after delivery. This in turn prevents the death of pregnant mothers due to lack of blood or bleeding. This is according to the findings from the study carried out by WHO and other researchers. The findings from the research showed that reducing the rate of smoking and also the intake of alcohol can help reduce the rate of maternal and children mortality.
Smoking causes various disease liked heart diseases, obesity and diabetes. This in turn affects the health of the mother and the child. Heart diseases, obesity and cardiovascular diseases have been associated with high maternal mortality and infant mortality in the world. This is according to the World health organization report. Reducing the risk factor for heart diseases, diabetes and obesity will help reduce the rate of maternal mortality in the country. Hence, pregnant women should adopt health life styles by reducing the rate of smoking and alcohol intake (Villar & Bergsjo, 1997).
Further, the findings from the research carried out by World health organization and other researchers like Villar, Bergsjo and Vittorio Basevi showed that ante natal care gives women an opportunity to get regular screening. Regular screening for various diseases like diabetes, heart diseases and obesity helps reduce maternal mortality and children mortality. Untreated gestation diabetes and abnormal pregnancy related glucose levels in pregnant mothers has serious effects on the mother and foetus. This is according to the results from the study carried out by WHO, Mario and Vittorio Basevi.
Pregnant mothers should be screened regular for various diseases. For example, the mothers should have regular check ups to determine the glucose level in the blood and check the amount of fats in the body. This will help lower the risk factor for diseases like diabetes, obesity and heart diseases. Thus, this will help reduce maternal deaths and infant deaths. The findings have shown that interventions l and treatments like dietary counseling, monitoring of blood glucose and insulin level can help improve the outcome of the mother and fetus (World health organization, Mario & Vittorio Basevi, 2005).
Additionally, the doctors should provide regular screening for the fetus to help reduce infant mortality. The doctor should screen the feotus for any abnormalities. This will help the doctors monitor the health of the feotus and the mother. In addition, to the feotus screening, the mother should bed screened for any infections. Bacterial infections and viral infections have led to high rate of maternal deaths and children deaths in Vietnam and in the world. Screening will help the doctors identify any infections among pregnant women and provide the right treatment. For instance, pregnant women should be screened for asymptomatic bacteriria. This helps reduce the risk of low birth weights among pregnant mothers. Also, the mothers should b e tested for Hepatitis B virus. The disease is transmitted from the mother to child. Screening will help reduce transmission of the disease and ensure the chinked is safe (WHO, UNICEF &UNFPA, 2004).
The doctors should monitor the wellbeing of the fotujs and the mother. Regular ultrasound in early pregnancy can help determine the gestation age and detect any multiple pregnancies. It also helps detect any complications in the fetus growth. Most pregnant women from rural areas and minority group’s are not able to access ante natal care. this makes it difficulty for the women to get nutrition supplements , screening and regular check ups. Hence, the high rate of deaths among pregnant women and children from rural areas. Moreover, providing pregnant women with the right education can help reduce the rate of maternal mortality and children mortality. The research carried out by World health organization, Mario and Vittorio Basevi showed that ante natal education combined with post natal education helps prevent maternal mortality and children mortality .
Pregnant women are supposed to be provided with education under ante natal care. The women are educated on various issues. For instance, the women are educated on how to eat healthily. The women are educated on the importance of eating a balanced diet. This will prevent them from contracting diseases and promote health growth of the fedotus. Also, the women are taught how to maintain healthy life styles such as regular exercise. exercise helps improve the outcome of pregnant women and the feotus as it reduces the risk factor for diseases like diabetes, obesity and heart diseases. Also, the mothers are advised on the negative effects of smoking and alcohol intake on their healthy and the health of the baby. Hence, its clear that ante natal care and nutritional program helps reduce the rate of maternal deaths and children deaths in the world. The ante natal care and nutritional program will help reduce maternal, and children mortality in rural, areas of Vietnam (WHO, UNICEF &UNFPA, 2004).
Method
Participants
The researcher will use 100 participants from the rural areas of Vietnam. The participants will be pregnant women aged 26 years and above. The participants will be selected randomly. This is to ensure the selection of the participants is not biased. Also, this will make the results of the research valid and reliable (World health organization, Mario & Vittorio Basevi, 2005).
Research design
The researcher will use the quantitative research design in his study. The research design will help him collect data from the participants and use it in the study. For example, the researcher will use questionnaires to collect data from the participants. The questioners will involve a set of questions that the participants will answer. The researcher can use the questions below to collect data from the participants.
- Do chronic diseases like obesity and heart diseases cause maternal deaths and children deaths due to lack of good maternal cared?
- Does lack of good diet lead to complications during pregnancy, hence resulting to the death of the mother and the baby?
- Do poor; lifestyles lead to high rate of maternal, deaths and children deaths?
- Does lack of ante natal education lead to high maternal deaths and children deaths? The participants will be required to answer the questions above according (World health organization, Mario & Vittorio Basevi, 2005).
Quantities research method gives the researcher an opportunity to use a large sample size. For example, the research method allows the research to use a sampled size of about 100 participants or more. This makes the research work more valid and reliable. In addition, the quantitative research method allows the researcher to use statistical methods to analyze or evaluate the data collected from the participants. In this case, the data collected from the participants will be analyzed using statistical methods like histograms and frequency tables. First, the researcher will code the results from the data collection process swell. For example, he can use 1 to represent Yes and 2 to represent No. Then after that , the researcher will tabulate the results in a frequency table and use graphs to determine (Villar & Bergsjo, 1997)
Expected outcome
The program is aimed at reducing the maternal deaths and children deaths in rural areas of Vietnam. The researcher will use different methods to determine if the program is effective or not. The program will be considered effective if it helps reduce the maternal mortality and infant mortality. The program should be able to reduce diseases that cause maternal deaths. For instance, the program should reduce the prevalence of diabetes, obesity and heart diseases. The pregnant women in rural areas of Vietnam should be able to get ante natal care so as to reduce the deaths. If the program does not reduce the maternal deaths and infant deaths in the area, then it will not be effective (Villar & Bergsjo, 1997).
Strengths and weakness in addressing the topic
The research may have some biasness. For instance, the biasness can result from the selection of participants. Most researchers find it difficulty to select the participants without biasness. Most participants in this research will be pregnant women from the rural areas. The participants should be selected randomly to help eliminate biasness. Also, biasness can also occur in the results as the participants will give different answer. Majority of the participants might support that lack of ante natal care and proper diet has increased maternal and children mortality. Others might not agree with the questions.
The researcher will evaluate and code the data collected well to avoid biasness. This will ensure the research results are not biased and are valid. There are various challenges that researchers face when carrying out research. The challenges include communication problems, lack of education and cultural factors. Another challenge is lack of corporation between the participants and the researcher. Most researchers lack enough education to carry out research.
This makes it difficulty for the researcher to collect data. Also, it makes it hard for the research to analyze the data collected. Also, cultural factors like language barrier have made it difficulty to gather enough data to be used in the study. Apart from cultural factors, most participants are not willing to communicate with the research. This makes it difficulty for the participants to give information. This in turn affects the validity and reliability of the data. The following materials will be required in order to help reduce maternal rated and infant mortality in the rural areas of Vietnam.
Drugs to be used to treat the pregnant women and help reduce maternal deaths. For instance, one will need drugs to treat diabetes, hypertension and obesity. Also, one will need supplements like iron supplement, calcium etc. Food supplies are also need to help provide the pregnant women with a balanced diet. Lastly, one will need personnel to help implement the program. That is doctors, nurses, community workers and family members. The personnel will work together to provide antenatal care and nutrition to pregnant women(Villar & Bergsjo, 1997).
Conclusion
Providing ante natal care and nutrition programs to pregnant women in rural areas of Vietnam can help reduce maternal deaths and child death. Maternal death and child death are caused by various factors. First, maternal deaths are caused by lack of ante natal care and nutrition. Most pregnant women do not get regular screening for chronic diseases like diabetes and obesity. This makes them more prone to the diseases and hence death. Also, the women do not get foists screening and ante natal dedication.
This has made it difficulty for the mothers to prevent maternal mortality. Providing good nutrition to the community will help reduce maternal deaths. This is because the mothers will be able to take balanced diet and supplements. This program is aimed at reducing maternal rate and infant mortality in the population. The researcher will use 100 participants from the area to collect data. Then after that he will analyze the data using statistical methods and make meaningful conclusion. Also, he will measure the effectiveness of the program. The program is considered effective if it reduces the maternal deaths and infant deaths in the region.
Reference
