Recognition and management of maternal sepsis continues to be a major cause of maternal mortality in low and middle-income countries (LMICs). A review of the literature on maternal sepsis was conducted using these electronic databases; Pubmed, Medline and Global Health. Shortcomings exist in the recognition, initial resuscitation and post-resuscitation monitoring and treatment of maternal sepsis. This is further complicated by a lack of trained healthcare professionals, adequate equipment and technologies, as well as intravenous fluids and antibiotics. International consensus on the identification and management of maternal sepsis in low-resource settings are lacking. The key to maternal sepsis management is timely recognition, aggressive resuscitation, antimicrobial therapy, source control, and continued monitoring and assessment. This review discusses ways of adapting research findings to maternal sepsis management where it is most needed in low and middle-income countries, which includes resuscitation via peripheral routes and reliance on clinical diagnosis. There is a need for low cost, technology advances to aid detection of sepsis and robust management pathways adapted to low-resource environments.

Recently, there has been a significant increase in individuals seeking refuge in many western countries. Upon arrival, refugee women face challenges in accessing and utilizing critical prenatal care. We conducted a mixed-methods study, combining a patient exit survey and focus groups to understand the experiences of multi-ethnic refugee women in accessing and utilizing a specialized prenatal care service in Arizona, United States-Refugee Women’s Health Clinic (RWHC). Clearly, refugee women recognized the importance of prenatal care. Self-motivation, support from partners, community members, and trained health advocates, who provide logistic and language support were critical drivers that promoted prenatal care utilization, as these drivers addressed any barriers that limited their capacity to engage. Those who engaged with RWHC had a positive opinion of it, evidenced also by the high satisfaction index scores, irrespective of ethnic background. Our research shows a clear justification to scale-up such specialized prenatal services for refugee women.