Table 1:
Identified problems associated with the MHP from the perspective of published articles
| Dimension | Identified Problems |
|---|---|
| Safety | High rate of medical errors; birth injuries; high-risk pregnancies; lack of safe delivery and safety culture; complaints from caregivers; and adverse health results for mothers such as blood pressure, cardiovascular disorders and respiratory problems |
| Technical | Inappropriate referral system; inadequate and with delay pregnancy visits; poor compliance of provided cares with the clinical guidelines standards; providing low quality cares, inability to manage pregnancy-related illnesses; undesirable health outcomes |
| Quality | Lack of support groups, timely care, early prevention and diagnosis of health problems, continuity of care, respect, safety, access to the services, initial facilities, empathy, responsiveness, reliability, confidentiality, and accountability; poor education of mothers and involving them; lack of access to blood bank; poor clinical equipment and physical environments |
| Quality of the services | High maternal mortality rate due to bleeding, high blood pressure, eclampsia and pre-eclampsia, embolism, puerperal pyrexia and mother’s underlying diseases |
| Maternal mortality | High infant mortality rate (and its inequity and inequality) due to congenital anomalies, prematurity, respiratory problems, blood infections, low birth weight, embryo problems, and … |
| Infant Mortality | Inappropriate gain weight during pregnancy than what is recommended due to bad nutrition, inappropriate intake of nutritional supplements, inadequate educations regarding nutritional habits, inappropriate pregnancy age, and anthropometric features of mothers |
| Nutrition status | High rates of cesarean due to cultural issues, previous cesarean deliveries, induced demand by physicians, lack of physiological birth facilities, and inadequate maternal education |
| Cesarean section | High rate of LBW inappropriate family planning, oligohydramnios, preterm labor history in mother, bleeding during pregnancy, cesarean, mother’s illness and employment, and living in rural areas |
| Low birth | High rate of gestational diabetes due to pregnancy age, history of gestational diabetes in mothers and relatives, the status of BMI, history of abortion and history of macrosomia |
| weight | High rate of premature delivery due to pre-eclampsia, placental disorder, idiopathic reasons, mother stress, violence and trauma in mother, smoking and drug use in mother, poor prenatal care, high number of pregnancies, diabetes, thyroid problems and heart diseases in mother |
| Gestational diabetes | The incompetence of the personnel working in MHP in areas such as managing pregnancy and delivery problems, maternal and child care, family planning, pregnancy-related diseases, managing the chronic diseases and exposure to traumatic events, and referral system |
| Early | High rate of psychological problems such as depression, fear of pregnancy and delivery, postpartum and delivery psychiatric disorders; and high rate of violence against mothers |
| delivery | Inappropriate health education provided to mothers particularly regarding physiological changes, risk factors and possible problems during pregnancy; importance of oral health and physical activity; and dangers of smoking cigarette and hookah |
| Healthcare providers competencies | Inequalities in health outcomes such as birth of premature infants and LBW, mothers low weight, maternal and infant mortalities, injuries, babies’ disabilities, births spacing, pregnancy at unsuitable age, breastfeeding, caesarean; and inequity in access to cares among different social and economic groups, geographical areas, and migrant |
| Psychological | High rate of problems such as oral and dental problems; anemia; quality of life; backache; headache; fatigue; infectious diseases; respiratory problems; retinopathy associated with prematurity; abdominal colitis; bleeding; and bronchitis |