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ABSTRACT. • . . • . • • . • • • • . • • • . • • • . • • • • • . • . • . i i
lI.CKNOWLEDGEMENTS. • • . • • • • • • . . • • . • • . • • . . . . i v
LIST OF TABLES . . . . . . . . . . . . ..... . . . . . . . . . viii
LI ST OF FIGURES. • • •. • • • • • • . . . • . • . . . • . • • .
CHAPTER 1 INTRODUCTION • .• • •• • .• . ... . .• .
CHAPTER 2 BACKGROUND IN FORMATION •. •..• • .
2 . 1 The country and study area . . . . . . 6
2.. 2. The study center.. .... .. . . . . . .. . 1 1
2 .3 Matc.mal health i n Gha na. .. . .. . . 14
CHAPTER J LI TERATURE REVIEW. . .. . . . . ... . . 18
J.1 Puerperal mortality.. . . .. . • • • • . • 21
3 . 2 The puerperal morbid i ties.. .. . .. 27
3.2 .1 Infectious morbidities.. .. . . 27
3.2. .2. Non-infectious morbidities . . 52
CHAPTER 4 METHODS• . •• . . •• • • •. .• • • • .• • • •.
4 .1 Study design . . .. . .. • . •.••• . • • • . . . 7 9
4.2 Study objectives. . • • . •. • . •• .• • . . . 79
4.3 Planning & t he considerations. .. . 8 0
4 .4 Study subjects . .. . . .... . . 8 1
4 .5 Enha nc i ng participation ... . . . . . . . 83
4 .6 Baseline d a t a . . .. . . . . . . . . . . ... . . . 8 4
4 . 7 Fol low -up assessment.. . . . ... .. . . . 85
4 .8 Operat ional definitions. . • • . • . .• . 89
4 .9 Non-attending subjects. . . • • • . •.• • 91
4 . 10 Laboratory investigations . . ... .. 93
4 . 11 Data mana gement & a na l y s i s . ... . . 9 4
CHAPTER 5 THE RESULTS. . ... . . .. .. . . .. .. .. 100
5 .1 Ba s e l i ne characteristics. . ... ... . 10 2
5 .2 Follow-up & morbidity.. . . • • . • • . . . 11 8
!i .3 I nc idence of morbidity.. .. . .. .. . . 146
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