Evaluation of the maternal deaths surveillance and response system at the health district level in Guinea in 2017 through digital communication tools

Millimouno, Tamba Mina; Sidibé, Sidikiba; Délamou, Alexandre; Bello, Kéfilath; Keugoung, Basile; Dossou, Jean‐Paul; Béavogui, Abdoul Habib; Meessen, Bruno

doi:10.1186/s12978-019-0671-3

Cited by 19 publications

(34 citation statements)

References 12 publications

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“…However; in this study only 55 (65.5%) and 8 (0.6%) of maternal and perinatal deaths were reviewed respectively. This finding (the maternal part) is higher than other studies from Kenya and Guinea that reported review of half of maternal deaths [34, 35]. In contrast, this finding is lower compared to the national target of 90% [31] and the finding from Uganda which reported review of 71% of maternal death and 33.3% of perinatal deaths [36].…”

Section: Discussionmentioning

confidence: 55%

Maternal and perinatal death surveillance and response in Ethiopia: Achievements, challenges and prospects

et al. 2019

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BackgroundMaternal and Perinatal Death Surveillance and Response (MPDSR) was a pilot program introduced in Tigray, Ethiopia to monitor maternal and perinatal death. However; its implementation and operation is not evaluated yet. Therefore, this study aimed to assess the implementation and operational status and determinants of MPDSR using a programmatic data and stakeholders involved in the program.MethodsInstitutional based cross-sectional study was applied in public health facilities (75 health posts, 50 health centers and 16 hospitals) using both qualitative and quantitative methods. Data were entered in to Epi-info and then transferred to SPSS version 21 for analysis. All variables with a p-value of ≤ 0.25 in the bivariate analysis were included in to multivariable logistic regression model to identify the independent predictors. For the qualitative part, manual thematic content analysis was done following data familiarization (reading and re-reading of the transcripts).ResultsIn this study, only 34 (45.3%) of health posts were practicing early identification and notification of maternal/perinatal death. Furthermore, only 36 (54.5%) and 35(53%) of health facilities were practiced good quality of death review and took proper action respectively following maternal/perinatal deaths. Availability of three to four number of Health Extension Workers (HEWs) (Adjusted Odds Ratio (AOR) = 6.09, 95%CI (Confidence Interval): 1.51–24.49), availability of timely Public Health Emergency Management (PHEM) reports (AOR = 4.39, 95%CI: 1.08–17.80) and participation of steering committee’s in death response (AOR = 9.19, 95%CI: 1.31–64.34) were the predictors of early identification and notification of maternal and perinatal death among health posts. Availability of trained nurse (AOR = 3.75, 95%CI: 1.08–12.99) and health facility’s head work experience (AOR = 3.70, 95%CI: 1.04–13.22) were also the predictors of quality of death review among health facilities. Furthermore; availability of at least one cluster review meeting (AOR = 4.87, 95%CI: 1.30–18.26) and uninterrupted pregnant mothers registration (AOR = 6.85, 95%CI: 1.22–38.54) were associated with proper response implementation to maternal and perinatal death. Qualitative findings highlighted that perinatal death report was so neglected. Community participation and intersectoral collaboration were among the facilitators for MPDSR implementation while limited human work force capacity and lack of maternity waiting homes were identified as some of the challenges for proper response implementation.ConclusionThis study showed that the magnitude of: early death identification and notification, review and response implementation were low. Strengthening active surveillance with active community participation alongside with strengthening capacity building and recruitment of additional HEWs with special focus to improve the quality of health service could enhance the implementation of MPDSR in the region.

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Section: Discussionmentioning

confidence: 55%

Maternal and perinatal death surveillance and response in Ethiopia: Achievements, challenges and prospects

et al. 2019

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“…Some key principles of the start-up industry were introduced4: such as putting one’s focus on just a few hypotheses, using a simplified digital solution to test them, introduce active monitoring and rapid identification and adoption of emerging lessons. The collective intelligence strategy applied to ‘hard data’—tested under district.team—proved to be particularly effective14 and popular among district managers. At the same time, it did also highlight that transforming health administrations into LO necessitates proper time and commitment 15…”

Section: Our Practice In Collective Learningmentioning

confidence: 99%

Learning for Universal Health Coverage

Meessen¹,

Akhnif

Kiendrébéogo

et al. 2019

BMJ Glob Health

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The journey to universal health coverage (UHC) is full of challenges, which to a great extent are specific to each country. ‘Learning for UHC’ is a central component of countries’ health system strengthening agendas. Our group has been engaged for a decade in facilitating collective learning for UHC through a range of modalities at global, regional and national levels. We present some of our experience and draw lessons for countries and international actors interested in strengthening national systemic learning capacities for UHC. The main lesson is that with appropriate collective intelligence processes, digital tools and facilitation capacities, countries and international agencies can mobilise the many actors with knowledge relevant to the design, implementation and evaluation of UHC policies. However, really building learning health systems will take more time and commitment. Each country will have to invest substantively in developing its specific learning systemic capacities, with an active programme of work addressing supportive leadership, organisational culture and knowledge management processes.

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“…Moreover, examining the viewpoint of health workers about the maternal mortality system, other studies have had a positive attitude towards this system, and considered its flexibility, acceptability and sensitivity to be valuable [ 17 , 18 ]. However, other studies have referred to underreporting of maternal deaths [ 1 ], failure to obtain the real causes of deaths, and the effect of health barriers on the system [ 7 , 19 , 20 ]. These studies have emphasized the need to modify surveillance system processes based on resolving structural problems and sensitizing health practitioners so that this system can be used as optimally as possible.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Iranian maternal mortality surveillance system and providing system improvement strategies: study protocol for strategy formulation

et al. 2020

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Background The implementation of the maternal mortality surveillance system in Iran has significantly reduced the incidence of maternal mortality. However, the pattern of the causes of the mortalities, which has remained constant over the years, are still concerning. This study aimed to explain the experiences of the actors of the Iranian maternal mortality surveillance and provide strategies for improving this system. Methods This research is a qualitative study to develop strategies, that will be conducted in two phases. In the first phase, purposive sampling will be performed, and the data will be collected based on the experiences of the Iranian maternal mortality surveillance system actors in Iran’s Ministry of Health and the selected universities (Shiraz, Isfahan, Tehran, Zahedan, Alborz, Shahrekord) through semi-structured interviews. Moreover, during this phase, some part of the data will be collected through random participation of the researcher in some maternal mortality committees of the selected universities. In order to carry out the second phase, a panel of experts will be set up to discuss the best strategies for improving the Iranian maternal mortality surveillance by considering the above results. Discussion The analysis of maternal mortality surveillance system needs to evaluate the experiences of the actors who are the policymakers of this system and can be effective in identifying its challenges. This analysis and formulation of the subsequent strategies can lead to maternal health indicators remaining within the range of international standards or even beyond those standards in Iranian universities and countries with similar surveillance system.

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Evaluation of the maternal deaths surveillance and response system at the health district level in Guinea in 2017 through digital communication tools

Cited by 19 publications

References 12 publications

Maternal and perinatal death surveillance and response in Ethiopia: Achievements, challenges and prospects

Maternal and perinatal death surveillance and response in Ethiopia: Achievements, challenges and prospects

Learning for Universal Health Coverage

Analysis of the Iranian maternal mortality surveillance system and providing system improvement strategies: study protocol for strategy formulation

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