Changing priorities in maternal and perinatal health in Gert Sibande District, South Africa

Bac, Martin; Pattinson, Robert Clive; Bergh, Anne‐Marie

doi:10.7196/samj.2019.v109i11.14098

Cited by 4 publications

(4 citation statements)

References 6 publications

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“…The study district was targeted for health systems strengthening support because of high maternal and child mortality. 35 Intensified efforts were specifically made to strengthen DSR in the district over several years, building on long-standing processes (24-hour reporting, CEMD and PPIP, CHIP). Besides these, DSR processes were accompanied by improved district clinical support with the introduction of district clinical specialist teams (DCST) and a new mechanism of coordination, referred to as the monitoring and response unit (MRU).…”

Section: Methodsmentioning

confidence: 99%

Practice of death surveillance and response for maternal, newborn and child health: a framework and application to a South African health district

et al. 2021

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ObjectiveTo assess the functioning of maternal, perinatal, neonatal and child death surveillance and response (DSR) mechanisms at a health district level.DesignA framework of elements covering analysis of causes of death, and processes of review and response was developed and applied to the smallest unit of coordination (subdistrict) to evaluate DSR functioning. The evaluation design was a descriptive qualitative case study, based on observations of DSR practices and interviews.SettingRural South African health district (subdistricts and district office).ParticipantsA purposive sample of 45 front-line health managers and providers involved with maternal, perinatal, neonatal and child DSR. The DSR mechanisms reviewed included a system of real-time death reporting (24 hours) and review (48 hours), a nationally mandated confidential enquiry into maternal death and regular facility and subdistrict mortality audit and response processes.Primary outcome measuresFunctioning of maternal, perinatal, neonatal and child DSR.ResultsWhile DSR mechanisms were integrated into the organisational routines of the district, their functioning varied across subdistricts and between forms of DSR. Some forms of DSR, notably those involving maternal deaths, with external reporting and accounting, were more likely to trigger reactive fault-finding and sanctioning than other forms, which were more proactive in supporting evidence-based actions to prevent future deaths. These actions occurred at provider and system level, and to a limited extent, in communities.ConclusionsThis study provides an empirical example of the everyday practice of DSR mechanisms at a district level. It assesses such practice based on a framework of elements and enabling organisational processes that may be of value in similar settings elsewhere.

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Section: Methodsmentioning

confidence: 99%

Practice of death surveillance and response for maternal, newborn and child health: a framework and application to a South African health district

et al. 2021

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“…This finding validates the findings of the study conducted in Ethiopia that community outreach services should be implemented to improve the knowledge of pregnant women about their condition and reduce the development of complications [ 29 ]. Findings of a study conducted in Gert Sibande in Mpumalanga also suggested that maternal outreach services should serve as an intervention for healthcare professionals to screen and refer to appropriate healthcare professionals as that will help to reduce the number of consultations and hospital admissions [ 42 ]. This study’s findings are comparable to those conducted in Australia, emphasizing that outreach programs lessen self-referrals.…”

Section: Discussionmentioning

confidence: 99%

Strategies to Reduce Maternal Death Rate and Improve the Provision of Quality Healthcare Services in Selected Hospitals of Vhembe District Limpopo Province

Mahada,

Tshitangano,

Mudau

2023

Nursing Reports

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The maternal death rate remains high in South Africa despite the availability of many existing strategies to improve the quality of service. A 30% increase in the maternal mortality rate was reported between 2020 and 2021, with Limpopo ranking fourth highest out of nine provinces. The Vhembe district maintained its position as the third-ranked area with a notably elevated maternal mortality rate. This study aimed to explore the strategies used to reduce the maternal death rate and improve the provision of quality maternal healthcare services based on participant experiences in selected hospitals of the Vhembe district, Limpopo Province. One hospital was purposively sampled from every four municipalities. A qualitative approach using a phenomenological design was employed. Twenty-eight participants were sampled using a convenience sampling method. The semi-structured interview guide was used to collect data, complemented by the use of an audio recorder, continuing until data saturation was reached. Data saturation was reached at the 20th participant; however, the researcher continued until 28 sampled participants were interviewed. An interpretative phenomenological analysis was used following the analytical stages of interpretative data analysis. The study proposal was ethically cleared by the University of Venda Ethics Committee (FHS/22/PH/08/3108). The results indicate that, despite implementing strategies to improve maternal healthcare services and reduce the maternal death rate, several factors, such as the lack of material resources, shortage of staff, incompetent staff and poor infection control, affect the quality of maternal health services in the Vhembe district. The Limpopo Department of Health and hospital management should ensure that hospitals have all the necessary resources and support healthcare professionals through in-service training to ensure the functionality of existing strategies.

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“…One such activity is enhancing systems of real-time mortality surveillance and associated governance structures to ensure coordinated responses, referred to as monitoring and response units at the subdistrict and district levels. 59,60 Synergistic strengthening of all health system components is central to the intervention portfolio. As an example, the HCWs in Facility A identified improved ward infection control (microlevel) as their QI project.…”

Section: Effectiveness Of Change Ideamentioning

confidence: 99%

Early Reflections on Mphatlalatsane, a Maternal and Neonatal Quality Improvement Initiative Implemented During COVID-19 in South Africa

Odendaal

Goga

Chetty

et al. 2022

Glob Health Sci Pract

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Responding to health workers' and managers' immediate needs related to coronavirus disease (COVID-19), followed by reprioritization and inclusion of a newly developed COVID-19 risk matrix, helped Mphatlalatsane staff to identify and mitigate disruptions to public sector maternal and neonatal health care (MNH) services in South Africa. n Mphatlalatsane demonstrates that agile and context-specific responses to crises, such as the COVID-19 pandemic, can mitigate such threats and maintain interventions to improve MNH services.

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Changing priorities in maternal and perinatal health in Gert Sibande District, South Africa

Cited by 4 publications

References 6 publications

Practice of death surveillance and response for maternal, newborn and child health: a framework and application to a South African health district

Practice of death surveillance and response for maternal, newborn and child health: a framework and application to a South African health district

Strategies to Reduce Maternal Death Rate and Improve the Provision of Quality Healthcare Services in Selected Hospitals of Vhembe District Limpopo Province

Early Reflections on Mphatlalatsane, a Maternal and Neonatal Quality Improvement Initiative Implemented During COVID-19 in South Africa

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