Confidential inquiries into maternal deaths: Modifications and adaptations in Ghana and Indonesia

Hussein, Julia; D’Ambruoso, Lucia; Armar‐Klemesu, Margaret; Achadi, Endang; Arhinful, Daniel; Izati, Yulia; Ansong-Tornui, Janet

doi:10.1016/j.ijgo.2009.04.007

Cited by 13 publications

(20 citation statements)

References 10 publications

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“…One barrier to conducting CE is the varying quality of documentation of management in relation to maternal deaths. Adapted CEs were piloted in Indonesia and Ghana (Hussein et al. 2009).…”

Section: Discussionmentioning

confidence: 99%

Substandard emergency obstetric care - a confidential enquiry into maternal deaths at a regional hospital in Tanzania

Sørensen

Elsass

Nielsen

et al. 2010

Tropical Medicine &Amp; International Health

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Summaryobjective (i) To identify clinical causes of maternal deaths at a regional hospital in Tanzania and through confidential enquiry (CE) assess major substandard care and make a comparison to the findings of the internal maternal deaths audits (MDAs); (ii) to describe hospital staff reflections on causes of substandard care.methods A CE into maternal deaths was conducted based on information available from written sources supplemented with participatory observations and interviews with staff. The compiled information was summarized and presented anonymously for external expert review to assess for major substandard care. Hospital based maternal deaths between 2006 and 2008 (35 months) were included. Of 68 registered maternal deaths sufficient information for reviewing was retrieved for 62 cases (91%).As a supplement, in-depth interviews with staff about the underlying causes of substandard care were performed.results The causes of death were infection (40%), abortion (25%), eclampsia (13%), post-partum haemorrhage (12%), obstructed labour (6%) and others (4%). The median time available for hospital staff to manage the fatal complication was 47 h. The CE identified major substandard care in 46 (74%) of the 62 cases reviewed. During the same time period MDA identified substandard care in 18 cases. Staff perceived poor organization of work and lack of training as important causes for substandard care. Local MDA was considered useful although time-consuming and sometimes threatening, and staff dedication to the process was questioned.conclusion Quality assurance of emergency obstetric care might be strengthened by supplementing internal MDA with external CE.keywords maternal deaths, substandard care, delays in emergency obstetric care, maternal death audit, confidential enquiries into maternal deaths, developing world.

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“…One barrier to conducting CE is the varying quality of documentation of management in relation to maternal deaths. Adapted CEs were piloted in Indonesia and Ghana (Hussein et al. 2009).…”

Section: Discussionmentioning

confidence: 99%

Substandard emergency obstetric care - a confidential enquiry into maternal deaths at a regional hospital in Tanzania

Sørensen

Elsass

Nielsen

et al. 2010

Tropical Medicine &Amp; International Health

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show abstract

“…• Engagement of district hospitals improves organization and quality of care [27]. • Flexible use of Confidential Enquiries of Maternal Deaths encourages use and conduct of MDRs including CEMD and audits [22]. • Combining MDRs and criteria-based audit improves quality and utilization (but not availability) of EmONC [20].…”

Section: Performance Accountabilitymentioning

confidence: 99%

Strengthening accountability for improved maternal and newborn health: A mapping of studies in Sub‐Saharan Africa

Hilber

Blake

Bohle

et al. 2016

Intl J Gynecology & Obste

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“…However, maternal mortality and near miss measurement actions are flexible and adaptable, based on the local circumstances such as man power, financial resources and area of coverage (health facility, community, local government, state and national). Measurement of near miss along with maternal death is an adaptation and a new concept (43). Similar modification of original United Kingdom pattern of confidential enquiries into maternal deaths had been carried out in Ghana and Indonesia (44).…”

Section: Organization Of Maternal Mortality and Near Miss Measurementsmentioning

confidence: 99%

Maternal death and near miss measurement: a case for implementation in developing countries in the sustainable development agenda, a review article

Adeleke¹

2017

Research Journal of Health Sciences

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Abstract"Ending preventable maternal mortality (EPMM) remains an unfinished agenda and one of the world's most critical challenges. Maternal health, well-being and survival must remain a central goal and investment priority in the sustainable development goal agenda". This statement from the World Health Organization (WHO) document Ending Preventable Maternal Death is most appropriate especially for developing nations.Using 2010 as baseline, the current global maternal health targets are achievement of average maternal mortality ratio (MMR) of 70/100,000 live births. Nations whose MMR are more than 420/100,000 live births (the group where Nigeria belong) should have MMR not higher than 140 by 2030.There was recognition of the need for improved measurement and data quality in other to track the progress or lack of it as we approach 2030. Maternal health services need to be accountable more than ever before. Maternal death and near miss measurement is one way to achieve this. In this paper a three levels of maternal death and near miss audit, surveillance and review is recommended for Nigeria and other developing nations. Both measurements can be done together.Maternal death measurement also called maternal death review (MDR), audit or surveillance answers pertinent questions about the death of pregnant women, how many died? Where did they died? When did they died? Why did they died? Can these deaths be prevented? When MDR is followed by response (evidence base intervention) it becomes MDRS and thereby eliminates all preventable deaths. Every maternity service department and hospital, state and national government should audit the outcome of maternal health care being provided as a matter of accountability.

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Confidential inquiries into maternal deaths: Modifications and adaptations in Ghana and Indonesia

Abstract: This study introduced practical ways to encourage the implementation of maternal death reviews, inquiries, and audits that are context specific and, therefore, acceptable to local practitioners.

Cited by 13 publications

References 10 publications

Substandard emergency obstetric care - a confidential enquiry into maternal deaths at a regional hospital in Tanzania

Substandard emergency obstetric care - a confidential enquiry into maternal deaths at a regional hospital in Tanzania

Strengthening accountability for improved maternal and newborn health: A mapping of studies in Sub‐Saharan Africa

Maternal death and near miss measurement: a case for implementation in developing countries in the sustainable development agenda, a review article

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