Evaluation of the maternal mortality surveillance system in Mutare district, Zimbabwe, 2014-2015: a cross sectional study

Abstract

IntroductionIn Zimbabwe the integrated disease surveillance and response guidelines include maternal mortality as a notifiable event reported through the Maternal Mortality Surveillance System (MMSS). A preliminary review of the MMSS data for Mutare district for the period January to June 2014 revealed that there were some discrepancies in cases notified and those captured on the T5 monthly return form. There were also delays in reporting of some maternal deaths. Poor reporting indicated shortcomings in the MMSS in Mutare district and we therefore sought to assess the performance of the maternal mortality surveillance system in Mutare district.MethodsA descriptive cross sectional study was conducted using Centers for Disease Control and Prevention updated guidelines for evaluating public health surveillance systems. A total of 64 health workers were enrolled into the study from 19 selected health facilities in Mutare district and 32 maternal death notification forms submitted in 2014 to the provincial office were reviewed to assess the quality of information on the forms. Interviewer administered questionnaires were used to collect information from enrolled health workers, the system's attributes namely usefulness, acceptability, simplicity, stability, data quality, timeliness and completeness were assessed and a checklist was used to assess availability of resources for the implementation of the maternal mortality surveillance. We also determined the cost of reporting each maternal death in Mutare district.ResultsHalf of the study participants gave the correct definition of a maternal death. All health workers participated and were willing to continue participating in the maternal mortality surveillance. Majority of health workers, 79.7% used data generated from the surveillance system and 59.5% found it easy to implement the system. A total of 32 death notification forms were reviewed and of these, 31 forms were forwarded to the national office and all did not reach the national office on time. Average completeness of notification forms was 76.0% and 53.1% of the forms had all the necessary accompanying documents. Reporting each maternal death was estimated to cost $28.65 in Mutare district.ConclusionThe strongest components of the maternal mortality surveillance system in Mutare district were usefulness and acceptability. Timeliness and completeness were the weaker components of the system. The system was found to be simple; however, resources were not adequately available in all health facilities.

Evaluation of Maternal Death Surveillance and Response System in Dewachefa Woreda, Oromia Zone, Amhara Region, Ethiopia, 2018

“…The average completeness of weekly report form of the woreda was 77.4%. This is consistent with the study conducted Zimbabwe 79% [9] and in Mutare district, Zimbabwe76% [10].…”

Triangulating data sources for further learning from and about the MDSR in Ethiopia: a cross-sectional review of facility based maternal death data from EmONC assessment and MDSR system

“…Multiple factors can affect the implementation of MDSR. Lack of awareness of the purpose and principles of MDSR among stakeholders, the existence of a blame culture, insufficient number of trained staff to implement MDSR, the unavailability of guidelines and tools, lack of commitment and financial resources all contribute to the implementation of MDSR [4][5][6][7][8][9][10][11][12][13]. These barriers may prevent compliance with national and global targets for MDSR and delay the establishment of functioning MDSR committees at all health facilities [14].…”

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

“…According to these studies, decrease in the maternal mortality ratio during the recent years, compared to 1990s, has been related to the use of this system [12][13][14][15][16]. 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 exibility, 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].…”