Maternal and Neonatal Death Review (MNDR): A Useful Approach to Identifying Appropriate and Effective Maternal and Neonatal Health Initiatives in Bangladesh

Biswas, Animesh; Rahman, Fazlur; Halim, Abdul; Eriksson, Charli; Dalal, Koustuv

doi:10.4236/health.2014.614198

Cited by 20 publications

(37 citation statements)

References 13 publications

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“…10 The Directorate General of Health Services (DGHS) in collaboration with the Directorate General of Family Planning (DGFP) conducted the initial piloting of the intervention in the district, Thakurgaon, with technical and implementation support from two non-government organizations, the CIPRB and UNICEF, Bangladesh. The financial supports was provided by Canadian CIDA (DFATD) and initially funded by the Department for International Development (DFID) & European Commission.…”

Section: Introductionmentioning

confidence: 99%

The Economic Cost of Implementing Maternal and Neonatal Death Review in a District of Bangladesh

Biswas

Halim²,

Rahman³

et al. 2016

Journal of Public Health Research

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IntroductionMaternal and neonatal death review (MNDR) introduced in Bangladesh and initially piloted in a district during 2010. MNDR is able to capture each of the maternal, neonatal deaths and stillbirths from the community and government facilities (hospitals). This study aimed to estimate the cost required to implement MNDR in a district of Bangladesh during 2010-2012.Materials and methodsMNDR was implemented in Thakurgaon district in 2010 and later gradually extended until 2015. MNDR implementation framework, guidelines, tools and manual were developed at the national level with national level stakeholders including government health and family planning staff at different cadre for piloting at Thakurgaon. Programme implementation costs were calculated by year of costing and costing as per component of MNDR in 2013. The purchasing power parity conversion rate was 1 $INT = 24.46 BDT, as of 31st Dec 2012.ResultsOverall programme implementation costs required to run MNDR were 109,02,754 BDT (445,738 $INT $INT) in the first year (2010). In the following years cost reduced to 8,208,995 BDT (335,609 $INT, during 2011) and 6,622,166 BDT (270,735 $INT, during 2012). The average cost per activity required was 3070 BDT in 2010, 1887 BDT and 2207 BDT required in 2011 and 2012 respectively. Each death notification cost 4.09 $INT, verbal autopsy cost 8.18 $INT, and social autopsy cost 16.35 $INT. Facility death notification cost 2.04 $INT and facility death review meetings cost 20.44 $INT. One death saved by MNDR costs 53,654 BDT (2193 $INT).ConclusionsProgrammatic implementation cost of conducting MPDR give an idea on how much cost will be required to run a death review system for a low income country settings using government health system.Significance for public healthMaternal and neonatal death review (MNDR) system in a low income county is one of the key indicators to improve quality of health care services. The MNDR also support in the reduction of maternal and newborn deaths. However, to run a comprehensive death review system need to know costs associated with the system. This is crucial in low income countries for planning and designing a public health intervention. Very few studies yet perform to look at the costs to run a death review system. This paper describes health economic cost of death review system in Bangladesh for future public health research in low income countries

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Section: Introductionmentioning

confidence: 99%

The Economic Cost of Implementing Maternal and Neonatal Death Review in a District of Bangladesh

Biswas

Halim²,

Rahman³

et al. 2016

Journal of Public Health Research

Self Cite

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“…In this case, we clearly demonstrated that only correct knowledge and awareness of actions could help both mother and baby survive. Although a number of initiatives already has been taken by the government to reduce the maternal and neonatal deaths in Bangladesh (23,24), it is important to broaden the focus on other contributing factors that may lead to the death of mother and baby due to, for example, a burn injury. Increasing community awareness and improving knowledge through education and mass media are two methods by which we can disseminate correct messages to help prevent such deaths in future.…”

Section: Discussionmentioning

confidence: 99%

Burn Injury of a Pregnant Mother in Rural Bangladesh: A Case Report

Biswas¹,

Dalal

Deave

et al. 2017

Health Scope

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Introduction: This paper describes a case of pregnant mother who died of burn injury in order to understand the societal factors related to the event. We reviewed the case in the rural community. Initially, the case was reported as a maternal death to maternal and neonatal death review (MNDR) system being conducted in Bangladesh within exiting health system to explore the medical and social causes of maternal and newborn deaths. However, during the verbal autopsy, it was found that the mother died of bun injury. Therefore, we performed detailed case study. Case Presentation: A woman aged 18 years was nine months pregnant in a rural community in Moheskhali upazila of Cox's Bazar district. During the wintertime, the mother feels cold and goes near to the oven in the yard to be warm. Suddenly, part of her clothing (Anchal of Sari) catches fire; she does not recognized and starts to walk towards her room. A neighbor notices and starts to shout. The woman scars and tries to run. The neighbors come with a bucket of water. By this time, the fire spreads over whole body and cloths. Immediately after the event, she is transferred to a medical college hospital. Conclusions: Doctors tried to do immediate cesarean section; however, they could not save the life of the baby inside. The mother who was severely burnt also died after 10 days. Rural community in Bangladesh still does not have adequate awareness and knowledge about risk of burn. The scarce knowledge of appropriate steps immediately after burn was explored. Moreover, delays in decision-making and transferring the patient to the facility were identified. Specific interventions need to be taken to increase knowledge and awareness in the community, which could save thousands of lives.

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“…MDNRs support the examination of each maternal and neonatal death in the community by performing 'verbal autopsies', which are used to understand the medical causes and contributing factors relating to maternal and neonatal deaths. [20][21][22] Within the MNDR system, the government has also initiated SA as a social intervention.…”

Section: Introductionmentioning

confidence: 99%

Social Autopsy of maternal, neonatal deaths and stillbirths in rural Bangladesh: qualitative exploration of its effect and community acceptance

Biswas

Rahman²,

Eriksson

et al. 2016

BMJ Open

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Objectives Social Autopsy (SA) is an innovative strategy where a trained facilitator leads community groups through a structured, standardised analysis of the physical, environmental, cultural and social factors contributing to a serious, non-fatal health event or death. The discussion stimulated by the formal process of SA determines the causes and suggests preventative measures that are appropriate and achievable in the community. Here we explored individual experiences of SA, including acceptance and participant learning, and its effect on rural communities in Bangladesh. The present study had explored the experiences gained while undertaking SA of maternal and neonatal deaths and stillbirths in rural Bangladesh. Design Qualitative assessment of documents, observations, focus group discussions, group discussions and in-depth interviews by content and thematic analyses. Results Each community's maternal and neonatal death was a unique, sad story. SA undertaken by government field-level health workers were well accepted by rural communities. SA had the capability to explore the social reasons behind the medical cause of the death without apportioning blame to any individual or group. SA was a useful instrument to raise awareness and encourage community responses to errors within the society that contributed to the death. People participating in SA showed commitment to future preventative measures and devised their own solutions for the future prevention of maternal and neonatal deaths. Conclusions SA highlights societal errors and promotes discussion around maternal or newborn death. SA is an effective means to deliver important preventative messages and to sensitise the community to death issues. Importantly, the community itself is enabled to devise future strategies to avert future maternal and neonatal deaths in Bangladesh.

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Maternal and Neonatal Death Review (MNDR): A Useful Approach to Identifying Appropriate and Effective Maternal and Neonatal Health Initiatives in Bangladesh

Cited by 20 publications

References 13 publications

The Economic Cost of Implementing Maternal and Neonatal Death Review in a District of Bangladesh

The Economic Cost of Implementing Maternal and Neonatal Death Review in a District of Bangladesh

Burn Injury of a Pregnant Mother in Rural Bangladesh: A Case Report

Social Autopsy of maternal, neonatal deaths and stillbirths in rural Bangladesh: qualitative exploration of its effect and community acceptance

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