Every death counts: Electronic tracking systems for maternal death review in India

Abstract

Maternal death review (MDR) is an important strategy to improve the quality of obstetric care and reduce maternal morbidity and mortality. MDR provides detailed information on various factors at community, facility, and district levels that influence maternal health outcomes. One of the key challenges is to analyze large volumes of data collected via a paper-based system that uses facility and community level forms. This database continues to expand quantitatively (multiple forms and data elements), which makes analysis of data increasingly difficult for timely management and analysis. The present paper describes the development process involved in linking the paper-based system with an electronic system for MDR in India. The lessons learnt from this experience can contribute to understanding how innovative technologies can be used to address large-scale public health issues in low-resource countries and in particular solutions to address maternal health.

Risk factors for maternal mortality among 1.9 million women in nine empowered action group states in India: secondary analysis of Annual Health Survey data

“…Moreover, in our study, more than half of the maternal deaths had not been previously recorded. Efforts to create a national electronic database for maternal death surveillance in India began in 2013, 14 but the progress is still limited, mainly due to lack of resources. 15 16 Our study identified two key modifiable health systems determinants of maternal mortality in the nine disadvantaged states-access to the health facility and quality of care.…”

Information management in Iranian Maternal Mortality Surveillance System

“…Since early 2015, an integrated mortality system has been implemented in the country for improvement of this problem and for ensuring the correct coding of the death causes and recording all deaths with collaboration of civil registration, forensics, and municipalities ( 34 ) and if the proper monitoring and commitment exists for implementation of this program at all levels, it would be an effective help in solving this problem. WHO has designed a guideline to the International Statistical Classification of Diseases-Maternal Mortality (ICD-MM) in order to prevent under-reporting and specifying correct code to the maternal death causes and improve the data quality, which is the basis of the intervention design to decrease the incidence of these deaths ( 35 ).Thus, it is better that the guidance offered in this guideline be considered in the integrated mortality system of Ministry of Health and its implementation be emphasized, so that, according to the results of different studies ( 31 , 33 , 36 – 38 ), the classification of maternal mortality can be implemented properly and under-reporting be prevented. The status of data dissemination and use axis was desirable.…”

Effective strategies for reducing maternal mortality in Isfahan University of Medical Sciences, 2014

“…According to these studies, some effective strategies in preventing maternal deaths consist of review of maternal mortalities,[ 20 21 ] women's knowledge about the risks of cesarean section, induction of labor and childbirth preparation classes, painless delivery, consulting sessions and elimination of fear of and anxiety about vaginal delivery,[ 22 23 ] students' training with an emphasis on evidence-based practice, adherence to the protocols, simulation of managing acute diseases, early detection and referral management of mothers,[ 24 25 ] planning based on research to identify the obstacles to access high-quality clinical services and cares,[ 26 27 ] design and implementation of an effective system of risk management to improve safety,[ 28 29 ] raising the level of public awareness, and increasing the level of women's education. [ 30 31 32 33 34 35 ]…”