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1. Measures of Maternal MortalityThree measures of maternal mortality are commonly used. First, the maternal mortality ratio

is expressed as the number of maternal deaths during a given time period per 100,000 live

births during the same period:

The MMR represents a measure of the risk of death once a woman has become pregnant. As

a ratio, it is not a true risk, as it involves two different populations, pregnant women and live

newborns. The ratio can be influenced by the prevalence of stillbirths as well as the

prevalence of induced abortions.

Second, the maternal mortality rateis the number of maternal deaths in a given period per

100,000 women of reproductive age during the same period:

The maternal mortality rate is a cause-specific mortality rate for women of reproductive agein the presence of other causes of death.

Third, the lifetime risk of maternal deathis the risk a woman has of dying during her

reproductive years, given current rates of fertility and the risk of maternal mortality. Given

the length of the reproductive period (about 35 years), the lifetime risk is calculated as [1 (1

maternal mortality rate)35] (AbouZahr and Wardlaw 2003).

Khama O. Rogo, John Oucho, and Philip Mwalali . Disease and Mortality in Sub-SaharanAfrica. 2nd edition. Chapter 16, Maternal Mortality

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1. Peripartum cardiomyopathy (Pub Med Health, 2012)Peripartum cardiomyopathy is a rare disorder in which a weakened heart is diagnosed within

the final month of pregnancy or within 5 months after delivery.

Causes, incidence, and risk factors

Cardiomyopathyoccurs when there is damage to the heart. As a result, the heart muscle

becomes weak and cannot pump blood efficiently. Decreased heart function affects the lungs,

liver, and other body systems.

Peripartum cardiomyopathy is a form ofdilated cardiomyopathyin which no other cause of

heart dysfunction (weakened heart) can be identified.

In the United States, peripartum cardiomyopathy complicates 1 in every 1,300 - 4,000

deliveries. It may occur in childbearing women of any age, but it is most common after age30.

Risk factors includeobesity,having a personal history of cardiac disorders such as

myocarditis,use of certain medications, smoking,alcoholism,multiple pregnancies, being

African American, and being malnourished.

2. By culture, we mean the shared values and beliefs of an organizationcommonlydescribed as the way we do things here. The culture also can be thought of as the

shared norms for behaviour in the organization, often motivated by unstated

assumptions. Culture is sometimes described as the unwritten rules of the

organization.

3. Climate, on the other hand, describes the prevailing influences on a particular area offunctioning (such as safety) at a point in time. Climate should be discussed in the

context of being the climate for something: safety, quality, service, etc. It reflects

employee perceptions about what gets rewarded, supported and expected in a

particular setting.

Thus, culture is something that is more deeply embedded and long term, taking longerto change and influencing organizational performance across many areas of

functioning. Climate, on the other hand, changes faster and more immediately reflects

the attention of leadership.

(Stricoff, 2005)

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