{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T08:36:31Z","timestamp":1792658191424,"version":"4.5.0"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2011,12,22]],"date-time":"2011-12-22T00:00:00Z","timestamp":1324512000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2012,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the impact of the introduction of the Service Compact with all Nigerians (SERVICOM) contract on maternal health at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective and comparative study of maternal deaths between 2004 and 2010 was carried out. The main outcome measures were yearly maternal mortality ratio (MMR), relative risk (RR) of maternal mortality, and presentation\u2013intervention interval. The yearly MMR and the RR of maternal mortality were compared with the figures from 2004, which represented the pre\u2010SERVICOM era.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 4916 live births and 54 maternal deaths during the study period, giving an MMR of 1098 per 100 000 live births. Pre\u2010eclampsia\/eclampsia was the most common direct cause (25.0%), followed by hemorrhage (18.8%) and sepsis (8.3%). Anemia (12.5%) was the most common indirect cause. There was a progressive reduction in MMR and RR of maternal mortality, with a corresponding increase in live births. The presentation\u2013intervention interval improved significantly from 2006.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A positive change in the attitude of health workers and the elimination of fee\u2010for\u2010service in emergency obstetric care would reduce type 3 delays in public health facilities, and consequently reduce maternal mortality.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.ijgo.2011.10.023","type":"journal-article","created":{"date-parts":[[2011,12,23]],"date-time":"2011-12-23T02:34:42Z","timestamp":1324607682000},"page":"197-200","source":"Crossref","is-referenced-by-count":28,"title":["Improving maternal mortality at a university teaching hospital in Nnewi, Nigeria"],"prefix":"10.1002","volume":"116","author":[{"given":"Anthony O.","family":"Igwegbe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George U.","family":"Eleje","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph O.","family":"Ugboaja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robinson O.","family":"Ofiaeli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,12,22]]},"reference":[{"key":"e_1_2_6_2_2","unstructured":"Millennium Project.Goals targets and indicators.http:\/www.unmillenniumproject.org\/goals\/gti.htm. 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Delivering Service in Nigeria: a Roadmap.http:\/www.servenigeria.com\/misc\/wendyreport.pdf"},{"key":"e_1_2_6_12_2","unstructured":"ObasanjoO. Inaugural address of the President of the Federal Republic of Nigeria Chief Olusegun Obasanjo at the end of the Special Retreat on Service Delivery in Nigeria (March 21 2004)http:\/\/www.servenigeria.com"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2008.1028"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.2307\/3583409"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.4103\/1596-3519.59575"},{"issue":"1","key":"e_1_2_6_16_2","first-page":"74","article-title":"A ten year review of maternal mortality in Sokoto, northern Nigeria","volume":"21","author":"Audu L.R.","year":"2002","journal-title":"West Afr J Med"},{"key":"e_1_2_6_17_2","volume-title":"ICF Macro. Nigeria Demographic and Health Survey 2008","author":"National Population Commission","year":"2009"},{"key":"e_1_2_6_18_2","volume-title":"Mother\u2013Baby Package: Implementing Safe Motherhood in Countries","author":"WHO","year":"1996"},{"issue":"2","key":"e_1_2_6_19_2","first-page":"1","article-title":"Maternal mortality at Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria. An eight year survey","volume":"4","author":"Obiechina N.J.A.","year":"2000","journal-title":"Trop J Med Res"},{"issue":"3","key":"e_1_2_6_20_2","first-page":"103","article-title":"Re\u2010positioning of service delivery in the Nigerian Health System\u2014the impact of SERVICOM on emergency and other services in a tertiary health facility","volume":"56","author":"Emejulu J.K.C.","year":"2010","journal-title":"World Med J"},{"issue":"2","key":"e_1_2_6_21_2","first-page":"135","article-title":"Reducing maternal mortality from ruptured uterus\u2014the Sokoto initiative","volume":"33","author":"Ahmed Y.","year":"2004","journal-title":"Afr J Med Med Sci"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.2307\/3583426"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/api.elsevier.com\/content\/article\/PII:S0020729211005972?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/api.elsevier.com\/content\/article\/PII:S0020729211005972?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1016%2Fj.ijgo.2011.10.023","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1016%2Fj.ijgo.2011.10.023","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.ijgo.2011.10.023","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T13:27:50Z","timestamp":1696512470000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1016\/j.ijgo.2011.10.023"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,12,22]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2012,3]]}},"alternative-id":["10.1016\/j.ijgo.2011.10.023"],"URL":"https:\/\/doi.org\/10.1016\/j.ijgo.2011.10.023","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,12,22]]}}}