Garner, PA; (1990) The epidemiology of maternal and neonatal health in Papua New Guinea. Doctoral thesis (M.D), UCL (University College London).

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Abstract

In 1986 a Rapid Rural Appraisal (RRA) conducted in the Wosera subdistrict of Papua New Guinea identified questions related to neonatal and maternal health that required applied research. This thesis describes the epidemiological health project that followed, whose three objectives were: to determine the size, gestation and body proportions of Wosera newborns; to describe maternal factors that might be important determinants of low birth weight; and to review findings in relation to district and national planning. A population based cross-sectional study of 1008 women was conducted. Women who were pregnant were followed up at antenatal clinics in a longitudinal study of pregnancy. Within a few days of delivery, these mothers and their newborns were visited at home. The results show maternal nutrition was poor, and was made worse by childbearing. Maternal malaria, anaemia and iron deficiency were common. Perinatal mortality was high and mean birthweight was lower than seen in many developing countries; however, the proportion preterm or acutely growth retarded newborns was similar to than seen in other population based studies. Wosera infant size may be a consequence of maternal stature, malaria, smoking and nutrition. Maternal compliance to weekly chloroquine prophylaxis through antenatal clinics was irregular; on the other hand, umbilical cord care packs were better received by the mothers, and reduced neonatal morbidity. In the Wosera, focused antenatal care will have a limited impact on neonatal mortality in the absence of socio-economic development. Women should be encouraged to stop smoking in pregnancy. There is potential for reducing perinatal mortality in village births by emphasising umbilical cord care and providing mothers with cord care packs. Nationally, there is a need to simplify the national antenatal standard drug protocol; and further research is needed on the standard management of anaemia in pregnant women.

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