Guidelines and tools for organizing and conducting maternal death reviews

Zinnen, Véronique; Delvaux, Thérèse; Leke, Robert J. I.

doi:10.1016/j.ijgo.2014.07.006

Cited by 14 publications

(31 citation statements)

References 11 publications

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“…Third, verbal autopsies and maternal death reviews are not performed to identify causes. These last strategies are best in identifying causes and evaluating quality of care in order to improve [11, 14, 15, 22]. …”

Section: Discussionmentioning

confidence: 99%

“…An elaborate clinical case summary of every pregnancy-related death was made according to the FIGO-LOGIC MDR: Clinical summary form tool [15]. Information on patients, health care providers and hospitals was kept strictly confidential.…”

Section: Methodsmentioning

confidence: 99%

“…The committee reviewed the cases and agreed to a mode of death, underlying cause, contributing factors and classified each death using WHO guidelines on applications of ICD-MM [12] . Substandard care factors were analysed according to an adapted version of the FIGO-LOGIC MDR Grid analysis of clinical case management form [15]. Due to lack of guidelines substandard care was defined as a deviation from ‘standard practice’ according to local clinicians.…”

Section: Methodsmentioning

confidence: 99%

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Maternal mortality audit in Suriname between 2010 and 2014, a reproductive age mortality survey

Kodan

Verschueren

Roosmalen

et al. 2017

BMC Pregnancy Childbirth

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BackgroundThe fifth Millennium Development Goal (MDG-5) aimed to improve maternal health, targeting a maternal mortality ratio (MMR) reduction of 75% between 1990 and 2015. The objective of this study was to identify all maternal deaths in Suriname, determine the extent of underreporting, estimate the reduction, audit the maternal deaths and assess underlying causes and substandard care factors.MethodsA reproductive age mortality survey was conducted in Suriname (South-American upper-middle income country) between 2010 and 2014 to identify all maternal deaths in the country. MMR was compared to vital statistics and a previous confidential enquiry from 1991 to 1993 with a MMR 226. A maternal mortality committee audited the maternal deaths and identified underlying causes and substandard care factors.ResultsIn the study period 65 maternal deaths were identified in 50,051 live births, indicating a MMR of 130 per 100.000 live births and implicating a 42% reduction of maternal deaths in the past 25 years. Vital registration indicated a MMR of 96, which marks underreporting of 26%. Maternal deaths mostly occurred in the urban hospitals (84%) and the causes were classified as direct (63%), indirect (32%) or unspecified (5%). Major underlying causes were obstetric and non-obstetric sepsis (27%) and haemorrhage (20%). Substandard care factors (95%) were mostly health professional related (80%) due to delay in diagnosis (59%), delay or wrong treatment (78%) or inadequate monitoring (59%). Substandard care factors most likely led to death in 47% of the cases.ConclusionDespite the reduction in maternal mortality, Suriname did not reach MDG-5 in 2015. Steps to reach the Sustainable Development Goal in 2030 (MMR ≤ 70 per 100.000 live births) and eliminate preventable deaths include improving data surveillance, installing a maternal death review committee, and implementing national guidelines for prevention and management of major complications of pregnancy, childbirth and puerperium.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Maternal mortality audit in Suriname between 2010 and 2014, a reproductive age mortality survey

Kodan

Verschueren

Roosmalen

et al. 2017

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

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“…An outline for good conduct of the session of MDAs was established. It emphasizes the need for an environment ensuring confidentiality, role sharing, good management of discussions in compliance with the principles and rules stated in the charter [ 3 – 5 ].…”

Section: Methodsmentioning

confidence: 99%

“…Most of these deaths are avoidable [ 2 , 3 ]. The combat against maternal mortality involves several strategies including implementation of audits of maternal death aiming to improve the quality of care [ 3 – 5 ]. The quality of these maternal death audits (MDAs) requires adherence to core principles (confidentiality, anonymity, non-accusation and lack of punishment), rules for communication between health workers and a good scheduling of audits sessions [ 3 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Inadequate programming, insufficient communication and non-compliance with the basic principles of maternal death audits in health districts in Burkina Faso: a qualitative study

et al. 2017

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BackgroundImplementation of quality maternal death audits requires good programming, good communication and compliance with core principles. Studies on compliance with core principles in the conduct of maternal death audits (MDAs) exist but were conducted in urban areas, at the 2nd or 3rd level of the healthcare system, in experimental situations, or in a context of skills-building projects or technical platforms with an emphasis on the review of “near miss”. This study aims to fill the gap of evidence on the implementation of MDAs in rural settings, at the first level of care and in the routine care situation in Burkina Faso.MethodsWe conducted a multiple-case study, with seven cases (health districts) chosen by contrasted purposive sampling using four criteria: (i) the intra-hospital maternal mortality rates for 2013, (ii) rural versus urban location, (iii) proofs of regular conduct of maternal death audits (MDAs) as per routine health information system, and (iv) the use of district hospital versus regional hospital for reference when the first mentioned does not exist. A review of audit records and structured and semi-structured interviews with staff involved in MDAs were conducted. The survey was conducted from 27 April to 30 May of 2015.ResultsThe results showed that maternal death audits (MDAs) were irregularly scheduled, mostly driven by critical events. Overall, preparing sessions, communication and the conduct of MDAs were most of the time inadequate. Confidentiality was globally respected during the clinical audit sessions. The principle of “no name, no shame, and no blame” was differently applied and anonymity was rarely preserved.ConclusionProgramming, communication, and compliance with the basic principles in the conduct of maternal death audits were inadequate as compared to the national standards. Identifying determinants of such shortcomings may help guide interventions to improve the quality of clinical audits.ResumeLa mise en œuvre d’audits de décès maternels de qualité nécessite une bonne programmation, une bonne communication et le respect des principes fondamentaux. Des études sur le respect des principes fondamentaux existent mais ont été menées dans les zones urbaines, le 2ème ou 3ème niveau du système de santé, dans des situations expérimentales, un contexte de projets de renforcement des compétences ou de plates-formes techniques, en mettant l’accent sur la revue des «near miss». Cette étude vise à combler le manque d’information sur la programmation et le respect des principes fondamentaux concernant le milieu rural, le niveau du système de santé qui est. le district sanitaire et la situation de routine au Burkina Faso.MéthodologieNous avons mené une étude de cas multiple dans 7 établissements de santé sélectionnés par échantillonnage raisonné contrasté selon 4 critères: milieu urbain ou rural, taux de mortalité maternelle dans les établissements de santé en 2013 (les données de l’année 2014 n’étant pas complètes à la rédaction du protocole), la déclaration des audits de décès maternels...

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Evaluation of the quality of maternal death review cycles in Burkina Faso

Congo¹,

Mèda

Millogo³

et al. 2022

Intl J Gynecology & Obste

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Objective To assess the quality of the maternal death review (MDR) cycle in selected health facilities in Burkina Faso in accordance with national standards. Methods A multiple case study using a qualitative approach performed in five health districts and two regional hospital centers in Burkina Faso. The facilities were chosen by contrasted purposive sampling based on hospital maternal mortality rate and urban or rural location. Structured and semistructured interviews were conducted and data analyzed thematically, horizontally, and vertically. Results Of the seven facilities included, six performed MDR. The MDR cycle was incomplete in five facilities because the implementation of recommendations had not been assessed. All cases of maternal death lacked vital information. Case analysis was not conducted in accordance with the national standards in most of the facilities. The action plans for implementing recommendations were not commonly used. Conclusion The MDR process and its various stages did not meet quality standards. Identifying the determinants leading to lack of adherence to MDR standards will contribute to optimal choice of interventions and improving good practices in health facilities.

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Guidelines and tools for organizing and conducting maternal death reviews

Cited by 14 publications

References 11 publications

Maternal mortality audit in Suriname between 2010 and 2014, a reproductive age mortality survey

Maternal mortality audit in Suriname between 2010 and 2014, a reproductive age mortality survey

Inadequate programming, insufficient communication and non-compliance with the basic principles of maternal death audits in health districts in Burkina Faso: a qualitative study

Evaluation of the quality of maternal death review cycles in Burkina Faso

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