What do we know about maternal and perinatal mortality and morbidity audits in sub-Saharan Africa? A scoping literature review

Abstract

Purpose -The purpose of this paper is to provide a situational overview of the facility-based maternal and perinatal morbidity and mortality audits (MPMMAs) in SSA, their current efficacy at reducing mortality and morbidity rates related to childbirth. Design/methodology/approach -This is a scoping literature review based on the synthesis of secondary literature. Findings -Not all countries in SSA conduct MPMMAs. Countries where MPMMAs are conducted have not instituted standard practice, MPMMAs are not done on a national scale, and there is no clear best practice for MPMMAs. In addition, auditing process of pediatrics and maternal deaths is flawed by human and organizational barriers. Thus, the aggregated data collected from MPMMAs are not adequate enough to identify and correct systemic flaws in SSA childbirth-related health care. Research limitations/implications -There are a few published literature on the topic in sub-Saharan Africa. Practical implications -This review exposes serious gaps in literature and practice. It provides a platform upon which practitioners and policy makers must begin to discuss ways of embedding mortality audits in SSA in their health systems as well as health strategies. Social implications -The findings of this paper can inform policy in sub-Saharan Africa that could lead toward better outcomes in health and well-being. Originality/value -The paper is original.

The Reliability of Maternal Audit Instruments to Assign Cause of Death in Maternal Deaths Review Process: A Systematic Review and Meta-Analysis

“…To reach the goals in strengthening the health system, the process analysis of MDR needs appropriate guidance for the key reviewers to identify the larger patterns of maternal deaths. In the absence of any clinical and health system standards to re ect the scienti c evidence, the reviewers of MDR could be biased to reach a consensus on the appropriateness of the care provided (3,31,32).…”

Prioritization of interventions in pursuit of maternal health policy objectives to mitigate stillbirth risks. An exploratory qualitative study at subnational level in Uganda

“…It may also have occured due to fear of repercussions in case the gap fell on the health worker during the audit processes. This is understandable as a previous scoping review on the same attributed the low uptake of MPDSR to fear of the potential for litigation from families [18]. In the context of the study setting, not all health workers that handled the mother get invited during the audit committee meeting but rather representatives from the maternity unit usually the in-charge and the health worker that conducted the final delivery.…”

Approaches, enablers, barriers and outcomes of implementing facility-based stillbirth and neonatal death audit in LMICs: a systematic review

“…6 However, progress in LMICs has been limited compared with high-income countries. 7 Stillbirth and neonatal death audit is the process of capturing information on the causes of deaths and analysing the QoC received, in a no-blame, interdisciplinary setting to improve the care provided to all mothers and babies. 6 Through the process, the hospital staff have an opportunity to learn from the cases audited and improve care.…”