Portable continuous wave Doppler ultrasound for primary healthcare in South Africa: can the EUnetHTA Core Model guide evaluation before technology adoption?

Posted on October 31, 2020

Globally, maternal and child mortality remain unacceptably high, despite signicant progress in recent years reducing them remains a priority for many governments. Particularly in sub-Saharan Africa (SSA), access to adequate essential reproductive health services remains one of the challenges towards achieving universal health coverage (UHC). Maternal mortality amounted to 533 deaths per 100000 live births in 2017, compared to 11 deaths per 100000 live births among high-income countries and 211 deaths per 100000 live births globally. The third-trimester stillbirth rate in SSA is approximately 10 times higher than in developed countries – 29 vs 3 per 1000 births. The Every Newborn Action Plan to end preventable deaths, endorsed by the United Nations member states at the World Health Assembly in 2014, set a stillbirth target of 12 per 1000 births or less by 2030. SSA countries are still far from achieving this goal. In many resource-poor settings, the availability and quality of care in health facilities are not sucient to hinder adverse maternal or fetal outcomes. While the use of conventional ultrasound diagnostics is a routine component of antenatal care in high-income countries, in many low- and middle-income Page 3/30 countries (LMICs), the only way to determine fetal growth rate at the primary care level is by palpation and measuring the symphysis fundal height (SFH) using tape measure. Small studies in LMICs have shown that the use of the conventional ultrasound directly inuences antenatal care (ANC) utilization, improving referral for detected conditions and gestational age dating, and increasing the use of hospital for deliveries.

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Published by Sanele Mntla

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