Improving maternal and child health systems in Fiji through a perinatal mortality audit

Raman, Shanti; Iljadica, Alexandra; Gyaneshwar, Rajat; Taito, Rigamoto; Fong, James

doi:10.1016/j.ijgo.2014.11.010

Cited by 9 publications

(24 citation statements)

References 15 publications

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“…In addition, PNG-specific may not be generalisable to the Pacific region. 3 Raman [35] 2015 Fiji Development and evaluation of a perinatal mortality audit system in 3 hospitals in Fiji. Program evaluation Mixed methods – perinatal audit data and key informant interviews.…”

Section: Resultsmentioning

confidence: 99%

“…Other interventions aimed to improve infrastructure, resources and equipment, such as: building staff houses and community health posts, renovations to existing health facilities, and increasing availability of various essential medical supplies, equipment and oxygen provision [ 31 , 32 ]. Several service-specific interventions aimed to improve morbidity and mortality audit systems [ 30 , 33 – 36 ], management of perinatal deaths and bereavement care [ 35 , 37 ], and antimicrobial prescribing practices [38] .…”

Section: Resultsmentioning

confidence: 99%

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Improving the quality of maternal and newborn care in the Pacific region: A scoping review

Wilson

Spotswood

Hayman

et al. 2020

The Lancet Regional Health - Western Pacific

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Background: Quality care is essential for improving maternal and newborn health. Low-and middleincome Pacific Island nations face challenges in delivering quality maternal and newborn care. The aim of this review was to identify all published studies of interventions which sought to improve the quality of maternal and newborn care in Pacific low-and middle-income countries.Methods: A scoping review framework was used. Databases and grey literature were searched for studies published between January 20 0 0 and July 2019 which described actions to improve the quality of maternal and newborn care in Pacific low-and middle-income countries. Interventions were categorised using a four-level health system framework and the WHO quality of maternal and newborn care standards. An expert advisory group of Pacific Islander clinicians and researchers provided guidance throughout the review process.Results: 2010 citations were identified and 32 studies included. Most interventions focused on the clinical service or organisational level, such as healthcare worker training, audit processes and improvements to infrastructure. Few addressed patient experiences or system-wide improvements. Enablers to improving quality care included community engagement, collaborative partnerships, adequate staff education and training and alignment with local priorities. Conclusions:There are several quality improvement initiatives in low-and middle-income Pacific Island nations, most at the point of health service delivery. To effectively strengthen quality maternal and newborn care in this region, effort s must broaden to improve health system leadership, deliver sustaining education programs and encompass learnings from women and their communities.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Improving the quality of maternal and newborn care in the Pacific region: A scoping review

Wilson

Spotswood

Hayman

et al. 2020

The Lancet Regional Health - Western Pacific

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“…The profile of neonatal morbidity and mortality in Solomon Islands is comparable to other low‐ and low‐middle income countries where mortality is highest in low birthweight or pre‐term neonates, and most deaths occurring in the first days of life are from intrapartum complications . Other countries in the region face similar challenges.…”

Section: Discussionmentioning

confidence: 87%

“…In Goroka Hospital, Papua New Guinea, very low birth rate, septicaemia and birth asphyxia where the most frequent causes of death for neonates . In Fiji, a study using a perinatal mortality audit showed delays in seeking care, and delay in the provision of adequate care at health facilities contributed to stillbirth and neonatal deaths …”

Section: Discussionmentioning

confidence: 99%

Cause‐specific neonatal morbidity and mortality in the Solomon Islands: An assessment of data from four hospitals over a three‐year period

Tosif

Jatobatu²,

Maepioh³

et al. 2019

J Paediatrics Child Health

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Aim: Data on stillbirths and neonatal morbidity and mortality in low-middle income Pacific Island Nations such as Solomon Islands is limited, partly due to weak health information systems. We describe the perinatal mortality and clinical factors associated with poor newborn outcomes at four hospitals in Solomon Islands. Methods: This was a registry based retrospective cohort study at three provincial hospitals and the National Referral Hospital (NRH) from 2014-2016 inclusive. Results: 23 966 labour ward births and 3148 special care nursery (SCN) admissions were reviewed. Overall still birth rate was 29.2/1000 births and the perinatal mortality rate was 35.9/1000 births. PNMR were higher in provincial hospitals (46.2, 44.0 and 34.3/1000) than at NRH (33.3/1000). The commonest reasons for admission to SCN across the hospitals were sepsis, complications of prematurity and birth asphyxia. SCN mortality rates were higher in the 3 provincial hospitals than at NRH (15.9% (95/598) vs. 7.9% (202/2550), P value <0.01). At NRH, the conditions with the highest case fatality rates were birth asphyxia (21.3%), congenital abnormalities (17.7%), and prematurity (15.1%). Up to 11% of neonates did not have a diagnosis recorded. Conclusions: The perinatal mortality rates are high and intrapartum complications, prematurity and sepsis are the main causes of morbidity and mortality for neonates at hospitals in Solomon Islands. Stillbirths account for 81% of perinatal deaths. These results are useful for planning for quality improvement at provincial level. Improved vital registration systems are required to better capture stillbirths and neonatal outcomes.

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“…Klode et al explained that the failure of professional collaboration was due to a lack of understanding and interpretation that was contrary to the role in collaboration so that the relationship between professionals was not well established [18]. The most common issue for professional is a lack of effective communication and teamwork [19]. In addition, Behruzi et al stated that collaboration in maternal care there are obstacles at the level of interaction such as lack of communication, at the organizational level due to the lack of interest in midwives and different philosophies in practice, and lack of professional resources [20].…”

Section: Discussionmentioning

confidence: 99%

Reducing Maternal Mortality: A Qualitative Study of Health Workers’ Expectation in Urban Area, Indonesia

Dewi

Sundari

Nursetiawan

et al. 2021

Open Access Maced J Med Sci

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BACKGROUND: Maternal mortality is a sentinel event used globally to monitor maternal health and the overall quality of reproductive health care. Globally, maternal mortality is mostly due to direct causes; apparently, it is not limited by the setting or geographic region. However, Indonesia has failed to achieve the Millenium Development Goals (MDGs) target for maternal mortality. AIM: This study aims to explore health workers' and stakeholders' expectations in maternal health services to reduce maternal mortality in urban areas. METHODS: It is qualitative research through naturalistic, conducted in one of the regencies in Indonesia, the urban area with the highest Maternal Mortality Rate (MMR) in one province by 2019. Data were obtained in the form of information from Focus Group Discussions (FGDs). FGDs were carried out with stakeholders at the Health Service level (n=3), first-level health facilities or public health centres (n=3), and advanced health facilities or hospitals (n=7). Data analysis in this study employed software (Nvivo Release 1.0) to utilise transcripts in coding and categorising. RESULTS: The expectations that emerged from health workers' perspectives in the field were an integrated system of collaboration between health facilities, affordability of Hospital with Comprehensive Emergency Obstetric Care (CEmOC) in action for maternal-neonatal referral urgency, and the skilled health workers as a golden opportunity. CONCLUSION: Health workers’ expectations can improve the quality of maternal health services in urban areas, thereby reducing the MMR with a system of collaboration between health facilities, the affordability of maternal-neonatal emergency referral facilities, and the availability of Obstetricians who standby.

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Improving maternal and child health systems in Fiji through a perinatal mortality audit

Abstract: The use of PMAs by health workers in Fiji and other Pacific island countries could potentially rectify gaps in maternal and neonatal service delivery.

Cited by 9 publications

References 15 publications

Improving the quality of maternal and newborn care in the Pacific region: A scoping review

Improving the quality of maternal and newborn care in the Pacific region: A scoping review

Cause‐specific neonatal morbidity and mortality in the Solomon Islands: An assessment of data from four hospitals over a three‐year period

Reducing Maternal Mortality: A Qualitative Study of Health Workers’ Expectation in Urban Area, Indonesia

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