Regine Unkels

• Obstetrician/Gynaecologist, MPH, DTM&H
• PhD Student at Karolinska Institutet

Planet Earth is threatened by the human population. Energy and resource use are far beyond the planet’s carrying capacity. Planetary Health suggests an alternative idea of prosperity as the best possible human health for all within planetary boundaries. This implies giving priority to ecology because human health depends ultimately on the integrity...

Background Patient autonomy is central to the provision of respectful maternity care. Enabling women to make decisions free of discrimination and coercion, and respecting their privacy and confidentiality can contribute to positive childbirth experiences. This study aimed to deepen the understanding of how patient autonomy is reflected through soci...

Introduction: Health management information systems are crucial for a country′s health service planning and monitoring. Research indicates that generated data is often of low quality or not used for decision-making in low-resource settings. Digitalization potentially alleviates these problems, but scale-up in these countries is hampered by unreliab...

Background The majority of women experience pain during childbirth. Offering and supporting women to use different methods for coping with pain is an essential competency for maternity care providers globally. Research suggests a gap between what women desire for pain management and what is available and provided in many low-and middle-income setti...

Background Women’s childbirth experiences provide a unique understanding of care received in health facilities from their voices as they describe their needs, what they consider good and what should be changed. Quality Improvement interventions in healthcare are often designed without inputs from women as end-users, leading to a lack of considerati...

Background Health service data from Health Management Information Systems is important for decision-making at all health system levels. Data quality issues in low-and-middle-income countries hamper data use however. Smart Paper Technology , a novel digital-hybrid technology, was designed to overcome quality challenges through automated digitization...

Health information systems are important for health planning and progress monitoring. Still, data from health facilities are often of limited quality in Low-and-Middle-Income Countries. Quality deficits are partially rooted in the fact that paper-based documentation is still the norm at facility level, leading to mistakes in summarizing and manual...

Introduction Health information management system data is collected for national planning and evaluation but is rarely used for healthcare improvements at subnational or facility-level in low-and-middle-income countries. Research suggests that perceived data quality and lack of feedback are contributing factors. We aimed to understand maternity car...

Introduction Health information management system data is collected for national planning and evaluation but rarely used for health care improvements at the sub-national or facility-level in low-and-middle-income countries. Research suggests that perceived data quality and lack of feedback are contributing factors. We aimed to understand maternity...

Background Health information systems are important for health planning and monitoring of progress. Still, data from health facilities are often of limited quality in Low-and-Middle-Income Countries. Quality deficits are partially rooted in the fact that paper-based documentation is still the norm at facility level, leading to mistakes in summarizi...

Background Insufficient reductions in maternal and neonatal deaths and stillbirths in the past decade are a deterrence to achieving the Sustainable Development Goal 3. The majority of deaths occur during the intrapartum and immediate postnatal period. Overcoming the knowledge-do-gap to ensure implementation of known evidence-based interventions dur...

The partograph is a useful tool for improving the quality of care during labour (pictorial overview of labour progress, clinical audit, training of health care workers and facilitating the transfer of care). The WHO recommends its use especially in under-resourced settings. Several studies have reported under-utilization of the partograph in such s...

Background The three delays model proposes that maternal mortality is associated with delays in: 1) deciding to seek care; 2) reaching the healthcare facility; and 3) receiving care. Previously, the majority of women who died were reported to have experienced type 1 and 2 delays. With increased coverage of healthcare services, we sought to explore...

Background: Community health workers (CHWs) can play vital roles in increasing coverage of basic health services. However, there is a need for a systematic categorisation of CHWs that will aid common understanding among policy makers, programme planners, and researchers. Objective: To identify the common themes in the definitions and descriptions o...

Background: Assessing the feasibility of conducting a prospective Reproductive Age Mortality Survey (RAMOS) study in the low-income setting of Mangochi District, Malawi to obtain cotemporaneous estimates of the number, cause of and conditions associated with maternal deaths (MD) in all women of reproductive age (WRA) (n = 207 688). Methods: MD a...

Appendix S1. Description of InterVA (Verbal Autopsy) model to assign cause of death.

Objective: To compare methodology used to assign cause of and factors contributing to maternal death. Design: Reproductive Age Mortality Study. Setting: Malawi. Population: Maternal deaths among women of reproductive age. Methods: We compared cause of death as assigned by a facility-based maternal death review team, an expert panel using t...

Objective To investigate the efficacy of a single prophylactic dose of ampicillin combined with metronidazole to prevent postcesarean section infections compared with a multiple day regimen in low-resource settings. DesignAn evaluator-blinded randomized, controlled, noninferiority trial. SettingTwo rural hospitals in Tanzania. PopulationOf 181 enro...

Laut Armutsbericht der Bundesrepublik Deutschland nehmen Kinder- und Familienarmut kontinuierlich zu. Viele der einzelnen Indikatoren für soziale Benachteiligung haben einen negativen Einfluss auf den Verlauf von Schwangerschaft, Geburt und postpartaler Phase. Daher muss auch in Deutschland mit relevanten gesundheitlichen Problemen für Frauen und K...

In August 2004 a 16-year-old primigravida was referred to our regional hospital from a health centre with prolonged obstructed labour. She had been in labour with ruptured membranes for 3 days. The patient could not be transferred earlier because no transport was available. On admission she had fever (temperature 40°C) and foul-smelling meconium-st...

A pregnancy after Mustard repair for transposition of the great arteries and ventricular septal defect with pulmonary stenosis is reported. The 23-year-old gravida 1 was treated with ACE inhibitors up to 26 weeks of gestation until cardiac medication was changed to dihydralazine. At 28 weeks of gestation the patient developed cardiac decompensation...

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Urapidil is an antagonist of postsynaptic alpha 1 receptors, which leads to a diminution of the increased blood pressure by reducing the peripheral vascular resistance. With this pilot study we examined, whether it is possible to reduce the pregnancy-induced-hypertension with urapidil postpartum. The postpartum dosage of dihydralazine was diminishe...

Die sechswöchige Zeit nach der Geburt, das Puerperium1, ist zumeist eine besondere Zeit im Leben der Familie und der Mutter. Das alltägliche Leben wird umgestaltet, um die neuen Bedürfnissen von Kind und Mutter berücksichtigen zu können. Es besteht ein besonders intensiver Bedarf nach Gesundheitsberatung (einschließlich Familienplanung), und die El...