{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:42:37Z","timestamp":1792798957737,"version":"4.5.0"},"reference-count":37,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Swedish International Development Cooperation Agency-SIDA","id":[{"id":"https:\/\/ror.org\/01fn7me06","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Muhimbili University of Health and Allied Sciences, Reproductive and Child Health subprogram","id":[{"id":"https:\/\/ror.org\/027pr6c67","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,10,10]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to explore experiences of communication as an element of quality of care, among women surviving a maternal near-miss event, thus women who nearly died but survived haemorrhage, or pre-eclampsia complication during pregnancy, childbirth or within 42 days of termination of pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A descriptive, phenomenological, qualitative study using semistructured interviews with women who survived a maternal near-miss in Southern Tanzania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The participants were recruited from two selected hospitals in Mtwara Region, where women sought child birth care and developed near-miss condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Participants for this study were women who experienced and survived a maternal near-miss event and who had lived in the study area for at least 1 year. Women were recruited using an adapted version of the WHO criteria for maternal near-miss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data collection<\/jats:title>\n                    <jats:p>We identified 16 women and were able to conduct 10 in-depth interviews with women at their homes, 4 weeks after they were discharged. The interviews were audiorecorded and transcribed and translated word for word from Kiswahili. Thematic analysis was used to identify emerging themes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three major themes evolved: (1) Being informed about the care and interaction, (2) Being engaged and encouraged and (3) Being afraid to ask questions. The study highlighted that good communication with women during the provision of care helped women feel grateful, supported and cared for. Women who were unconscious during care were often not informed later of what happened. This created some negative feelings and anxiety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study highlights the importance of communication, and of being informed of what happened and why. Empathetic communication with sufficient explanation on what happened and why created trust among women\u2014a positive finding which should encourage the development of consistent approaches to strengthen healthcare provider communication skills.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-045514","type":"journal-article","created":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T13:16:32Z","timestamp":1635772592000},"page":"e045514","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["How communication can help women who experience a maternal near-miss: a qualitative study from Tanzania"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5790-1916","authenticated-orcid":false,"given":"Hilda Alinda","family":"Kwezi","sequence":"first","affiliation":[{"name":"Department of Community Health Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian T","family":"Mselle","sequence":"additional","affiliation":[{"name":"Department of Clinical Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebalda","family":"Leshabari","sequence":"additional","affiliation":[{"name":"Department of Community Health Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8066-7873","authenticated-orcid":false,"given":"Claudia","family":"Hanson","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea Barnabas","family":"Pembe","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,11,1]]},"reference":[{"key":"2025121601145786000_11.11.e045514.1","unstructured":"\"WHO\", \"UNICEF\", \"UNFPA\", \"WBG\" and the \"UNPD\" . 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Rockville, Maryland, USA: MoHCDGEC, MoH, NBS,OCGS and ICF, 2016."},{"key":"2025121601145786000_11.11.e045514.5","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-019-2225-7","article-title":"Applicability of the who maternal near miss tool in sub-Saharan Africa: a systematic review","volume":"19","author":"Tura","year":"2019","journal-title":"BMC Pregnancy Childbirth"},{"key":"2025121601145786000_11.11.e045514.6","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-017-1370-0","article-title":"Validating the who maternal near miss tool: comparing high- and low-resource settings","volume":"17","author":"Witteveen","year":"2017","journal-title":"BMC Pregnancy Childbirth"},{"key":"2025121601145786000_11.11.e045514.7","first-page":"1","article-title":"Evaluating the quality of care for severe pregnancy complications: the who near-miss approach for maternal health","volume":"87","author":"Pattinson","year":"2011","journal-title":"Bull World Health Organ"},{"key":"2025121601145786000_11.11.e045514.8","first-page":"10","article-title":"Application of WHO 'Near-Miss' Tool Indicates Good Quality of Maternal Care in Rural Healthcare Setting in Uttarakhand, Northern India","volume":"10","author":"Bakshi","year":"2016","journal-title":"J Clin Diagn Res"},{"key":"2025121601145786000_11.11.e045514.9","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006676"},{"key":"2025121601145786000_11.11.e045514.10","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldg007"},{"key":"2025121601145786000_11.11.e045514.11","doi-asserted-by":"crossref","DOI":"10.1186\/1742-4755-11-31","article-title":"Lived experiences of women who developed uterine rupture following severe obstructed labor in Mulago Hospital, Uganda","volume":"11","author":"Kaye","year":"2014","journal-title":"Reprod Health"},{"key":"2025121601145786000_11.11.e045514.12","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0130452","article-title":"Metasynthesis: experiences of women with severe maternal morbidity and their perception of the quality of health care","volume":"10","author":"Norhayati","year":"2015","journal-title":"PLoS One"},{"key":"2025121601145786000_11.11.e045514.13","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-13-174"},{"key":"2025121601145786000_11.11.e045514.14","unstructured":"World Health Organization . 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