Audits de décès maternels dans les pays à faibles ressources : analyse d’implantation dans 23 établissements de santé au Sénégal et au Mali (essai QUARITE)

Dortonne, Jean Richard; Dumont, Alexandre; Traoré, Mamadou; Perreault, Gilles; Couturier, François; Kanoute, K

doi:10.1016/s1701-2163(16)34323-7

Cited by 5 publications

(15 citation statements)

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“…Some leaders may misinterpret it as a tool for disciplining staff, 71 resulting in a well‐justified fear of blame 52 . All health workers need knowledge of clinical protocols and good record‐keeping skills so that committees can access the information needed to identify cause of death and avoidable factors 38,45,48,52 . Data collectors need specific skills on completing relevant forms, and interviewing/verbal autopsy where relevant 1,39 .…”

Section: Resultsmentioning

confidence: 99%

“…Where staff are expected to work or meet outside normal working hours, some expect extra pay 35,70 . Effective supervision requires the time of senior experts and their travel to relevant health facilities 38 . Involvement of communities requires additional staff time and transport to conduct interviews and meetings and respect for traditions such as paying condolences 1,18,20,66 …”

Section: Resultsmentioning

confidence: 99%

“…Physical opportunities to implement MPDSR can be improved by ensuring data quality, such as integrated and user‐friendly death reporting systems, 52 structured medical records, 39 secure and organized filing of medical records, 48 optimized MPDSR forms, and structured supervision forms 38 . It is equally important to ensure that resources are sufficient, by embedding MPDSR into routine health services and ensuring that funds are available for necessary expenses such as stationery and transport, as well as implementing recommendations.…”

Section: Resultsmentioning

confidence: 99%

“…Chairpersons and leaders also need skills in leadership, 21,38,39 chairing, 37 maintaining confidentiality, 48 coaching, 42 and budgeting 33 . Mentors/supervisors of the leaders need additional mentorship skills 38 . In several contexts, teams only had experience of reviewing maternal deaths and expressed a need for specific training on reviewing perinatal/neonatal deaths 71,72 …”

Section: Resultsmentioning

confidence: 99%

“…In parallel, motivation of health workers will be automatically increased if implementation becomes part of their professional role and becomes embedded in their working schedules. Involving relevant stakeholders in review meetings and formulating recommendations will enable them to take ownership and responsibility for implementing them 9,25,27,28,38,39,48,49 . It is also crucial to have a system to follow‐up and monitor the implementation of recommendations 23,27,48,53 …”

Section: Resultsmentioning

confidence: 99%

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Determinants of behaviors influencing implementation of maternal and perinatal death surveillance and response in low‐ and middle‐income countries: A systematic review of qualitative studies

Willcox,

Okello,

Maidwell‐Smith

et al. 2023

Intl J Gynecology & Obste

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BackgroundMaternal and Perinatal Death Surveillance and Review (MPDSR) can reduce mortality but its implementation is often suboptimal, especially in low‐ and middle‐income countries (LMICs).ObjectivesTo understand the determinants of behaviors influencing implementation of MPDSR in LMICs (through a systematic review of qualitative studies), in order to plan an intervention to improve its implementation.Search StrategyTerms for maternal or perinatal death reviews and qualitative studies.Selection CriteriaQualitative studies regarding implementation of MPDSR in LMICs.Data Collection and AnalysisWe coded the included studies using the Theoretical Domains Framework and COM‐B model of behavior change (Capability, Opportunity, Motivation). We developed guiding principles for interventions to improve implementation of MPDSR.Main ResultsFifty‐nine studies met our inclusion criteria. Capabilities required to conduct MPDSR (knowledge and technical/leadership skills) increase cumulatively from community to health facility and leadership levels. Physical and social opportunities depend on adequate data, human and financial resources, and a blame‐free environment. All stakeholders were motivated to avoid negative consequences (blame, litigation, disciplinary action).ConclusionsImplementation of MPDSR could be improved by (1) introducing structural changes to reduce negative consequences, (2) strengthening data collection tools and information systems, (3) mobilizing adequate resources, and (4) building capabilities of all stakeholders.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Determinants of behaviors influencing implementation of maternal and perinatal death surveillance and response in low‐ and middle‐income countries: A systematic review of qualitative studies

Willcox,

Okello,

Maidwell‐Smith

et al. 2023

Intl J Gynecology & Obste

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Barriers to the implementation of quality maternal death reviews in health districts in Burkina Faso

Congo¹,

Yaméogo²,

Millogo³

et al. 2022

Intl J Gynecology & Obste

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Objective To identify barriers to the implementation of maternal death reviews in health districts in Burkina Faso. Methods We conducted a multiple case study in seven health facilities chosen by contrasted purposive sampling. Sampling criteria were based on intrahospital maternal mortality rates and the location of the health facility. Data collection was conducted from April 27 to May 30, 2015, using structured and semistructured interviews and data extraction from source documents. Data were analyzed using a thematic approach. Results Barriers to quality maternal death reviews identified were primarily implementation conditions, including poor skills and motivation of healthcare personnel, low interest in quality of care, lack of suitable equipment, insufficient coordination and collaboration between health services, insufficient monitoring, and weakness in programming and conducting the reviews. Conclusion Barriers to achieving quality maternal death reviews remain numerous at the operational level of the health system. Taking steps to remove these barriers is key to improving the quality of maternal death reviews and childbirth outcomes in Burkina Faso.

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The conduct of maternal and perinatal death reviews in Oyam District, Uganda: a descriptive cross-sectional study

et al. 2016

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BackgroundUganda like many developing countries still experiences high levels of maternal and perinatal deaths despite a decade of maternal and perinatal death review (MPDR) program. Oyam district has been implementing MPDR since 2008 with varying successes among the health facilities. This paper presents the factors that influence the conduct of maternal and perinatal death reviews in Oyam District, Uganda.MethodsThis was a cross-sectional study where both qualitative and quantitative data were collected. Semi-structured interviews were administered to 66 health workers and ten key informants (KIs) to assess the factors influencing the conduct of MPDR. Univariate and Bivariate analysis of quantitative data was done using SPSS version 17.0. A Pearson Chi-Square test was done to determine factors associated with conduct of MPDR. Factors with a p-value < 0.05 were considered statistically significant. Qualitative data was analyzed using content analysis.ResultsOnly 34.8 % of the health workers had ever participated in MPDR. The factors that influenced conduct of MPDR were existence of MPDR committees (p < 0.001), attendance of review meetings (p < 0.001) and knowledge of objectives of MPDR (p < 0.001), implementation of MPDR recommendations (p < 0.001), observed improvement in maternal and newborn care (p < 0.001) and provision of feedback (p < 0.001). Hindrance to conduct of MPDR was obtained from KIs: the health workers were not made aware of the MPDR process, committee formation and training of MPDR committee members was not effectively done, inadequate support supervision, and lack of financial motivation of MPDR committee members. Challenges to MPDR included: heavy workload to health workers, high number of perinatal deaths, and non-implementation of recommendations.ConclusionThe proportion of maternal and perinatal death reviews conducted in Oyam was low. This was due to poor initiation of the review process and a lack of support supervision. The district and Ministry of Health needs to put more emphasis on monitoring the conduct of maternal and perinatal death reviews by: forming and training MPDR committees and ensuring they are financially supported, providing overall coordination, and ensuring effective support supervision.Electronic supplementary materialThe online version of this article (doi:10.1186/s12905-016-0315-5) contains supplementary material, which is available to authorized users.

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Audits de décès maternels dans les pays à faibles ressources : analyse d’implantation dans 23 établissements de santé au Sénégal et au Mali (essai QUARITE)

Cited by 5 publications

References 2 publications

Determinants of behaviors influencing implementation of maternal and perinatal death surveillance and response in low‐ and middle‐income countries: A systematic review of qualitative studies

Determinants of behaviors influencing implementation of maternal and perinatal death surveillance and response in low‐ and middle‐income countries: A systematic review of qualitative studies

Barriers to the implementation of quality maternal death reviews in health districts in Burkina Faso

The conduct of maternal and perinatal death reviews in Oyam District, Uganda: a descriptive cross-sectional study

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