Childbirth outcomes and ethnic disparities in Suriname: a nationwide registry-based study in a middle-income country

Verschueren, Kim J.C.; Prüst, Zita D.; Paidin, Raëz R.; Kodan, Lachmi R.; Bloemenkamp, Kitty W. M.; Rijken, Marcus J.; Browne, Joyce L.

doi:10.1186/s12978-020-0902-7

Cited by 18 publications

(30 citation statements)

References 27 publications

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“…The ethnic distribution in Suriname is Hindustani (27%), Maroon (22%), Creole (16%), Javanese (14%), Mixed (13%), Indigenous (4%), Chinese (1%) and Other (3%) in 2018 [12,14,15]. Suriname's ethnic diversity reflects its history.…”

Section: Study Settingmentioning

confidence: 99%

“…Mixed ethnicities are the result of interchanging identities between almost all ethnicities. Other ethnicities include Brazilians, Caucasians (descendants of Dutch colonists) and a few Lebanese [12,15]. Maroon and Indigenous women belong to the poorest quartile of Suriname [15].…”

Section: Study Settingmentioning

confidence: 99%

“…Each hospital digitalised the childbirth book of 2017 with the assistance of one of the authors (ZP). The availability of variables was described elsewhere [12]. In brief, basic childbirth data (e.g.…”

Section: Data Collectionmentioning

confidence: 99%

“…A previous nationwide study on perinatal outcomes in Suriname, South America, in 2016 and 2017 reported an SBR of 14.8 per 1000. This ranked Suriname with the second-highest SBR of Latin America and the Caribbean [11,12]. The reason for Suriname's high SBR is unknown.…”

Section: Introductionmentioning

confidence: 96%

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Investigation of stillbirth causes in Suriname: application of the WHO ICD-PM tool to national-level hospital data

Prüst

Verschueren

Bhikha-Kori

et al. 2020

Global Health Action

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Background: Suriname has one of the highest stillbirth rates in Latin America and the Caribbean. To facilitate data comparison of perinatal deaths, the World Health Organization developed the International Classification of Diseases-10 Perinatal Mortality (ICD-PM). Objective: We aimed to (1) assess characteristics and risk indicators of women with a stillbirth, (2) determine the timing and causes of stillbirths according to the ICD-PM with critical evaluation of its application and (3) propose recommendations for the reduction of stillbirths in Suriname. Methods: A hospital-based, nationwide , cross-sectional study was conducted in all hospitals within Suriname during one-year (2017). The medical files of stillbirths (gestation ≥28 weeks/ birth weight ≥1000 grams) were reviewed and classified using ICD-PM. We used descriptive statistics and multiple logistic regression analyses. Results: The stillbirth rate in Suriname was 14.4/1000 births (n=131 stillbirths, n=9089 total births). Medical files were available for 86% (n=113/131) of stillbirths. Women of African descent had the highest stillbirth rate and two times the odds of stillbirth (OR 2.1, 95%CI 1.4-3.1) compared to women of other ethnicities. One third (33%, n=37/113) of stillbirths occurred after hospital admission. The timing was antepartum in 85% (n=96/113), intrapartum in 11% (n=12/113) and unknown in 4% (n=5/113). Antepartum stillbirths were caused by hypoxia in 46% (n=44/96). In 41% (n=39/96) the cause was unspecified. Maternal medical and surgical conditions were present in 50% (n=57/113), mostly hypertensive disorders. Conclusion: Stillbirth reduction strategies in Suriname call for targeting ethnic disparities, improving antenatal services, implementing perinatal death audits and improving diagnostic post-mortem investigations. ICD-PM limited the formulation of recommendations due to many stillbirths of 'unspecified' causes. Based on our study findings, we also recommend addressing some challenges with applying the ICD-PM.

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Section: Study Settingmentioning

confidence: 99%

Section: Study Settingmentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

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Investigation of stillbirth causes in Suriname: application of the WHO ICD-PM tool to national-level hospital data

Prüst

Verschueren

Bhikha-Kori

et al. 2020

Global Health Action

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“…Facility-based trainings, guided by BOG and PAHO and the recently installed maternal health quality of care committee, were conducted to enhance guideline implementation and adherence, as advised in earlier studies [6,7]. In addition to quality of care improvement projects, committee MaMS was involved in conducting nationwide studies on maternal morbidity and near-miss (2017-2019), childbirth outcomes, and ethnic disparities in maternal health care and stillbirths [33,34]. To improve perinatal and maternal health, we need to focus on the speci c gaps in care identi ed by these studies.…”

Section: Maternal Mortality Surveillance Between 2015 and 2019mentioning

confidence: 99%

From Passive Surveillance to Response: Suriname's Steady Efforts to Implement Maternal Death Surveillance and Response (MDSR)

Kodan

Verschueren

Boerstra

et al. 2020

Preprint

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Background Maternal death surveillance and response (MDSR) is essential in preventing avoidable maternal deaths. The cycle starts by accurately capturing maternal deaths with a surveillance system, followed by an audit to give insight into the underlying causes and "lessons learned." Subsequently, recommendations are formulated and targeted multisectoral responses such as quality of care improvement strategies, including clinical guidelines update, health promotion interventions, research to fulfill knowledge gaps, enabling policies and legislation and interventions addressing social determinants. Finally, continuous evaluation and monitoring close the MDSR cycle. We aim to describe the MDSR implementation process in Suriname to share valuable lessons with other countries.Methods We provide an overview of the evolvement from improved maternal death surveillance, toward review, response, and monitoring to fulfill the MDSR cycle in Suriname. Findings Middle-income country Suriname called for many years for improved surveillance and review, and in 2000 the first action was commenced by extension of maternal death case capturing from death certificates to active hospital surveillance. Consequently, the maternal mortality ratio increased in the following years. However, not the full MDSR cycle was completed in 2015, and local health care providers initiated the next step of the MDSR cycle with the installation of a national maternal death review committee (MaMS). Since then, the committee reviews each maternal death applying the "no blame, no shame" culture, formulates, and disseminates recommendations. Collaboration with the Ministry of Health (MOH), Bureau of Public Health (BOG), and the Pan American Health Organization (PAHO) should ensure progress to the sustainable implementation of MDSR. Committee MaMS demonstrates that maternal death review and recommended high impact interventions can only be effectively implemented and sustained, through strong professional and government commitment and practical, solution-oriented responses. Conclusions Crucial elements for a successful MDSR implementation are Commitment, "no blame, no shame" Culture, Coordination, Collaboration, and Communication (5 C's).We hope that describing this process toward successful nationwide MDSR implementation, with its facilitators and barriers, is helpful for other countries with similar ambitions.

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The United States reference values of the Bayley III motor scale are suitable in Suriname

Fleurkens-Peeters,

Zijlmans,

Akkermans

et al. 2024

Infant Behavior and Development

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Childbirth outcomes and ethnic disparities in Suriname: a nationwide registry-based study in a middle-income country

Cited by 18 publications

References 27 publications

Investigation of stillbirth causes in Suriname: application of the WHO ICD-PM tool to national-level hospital data

Investigation of stillbirth causes in Suriname: application of the WHO ICD-PM tool to national-level hospital data

From Passive Surveillance to Response: Suriname's Steady Efforts to Implement Maternal Death Surveillance and Response (MDSR)

The United States reference values of the Bayley III motor scale are suitable in Suriname

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