Maternal Death Audit: Experience from a Periurban Hospital

Kabir, Nazneen; Rahman, Altaf Ur; Ahmed, Anisuddin; Chowdhury, Sameena

doi:10.3329/jbcps.v24i1.139

Cited by 4 publications

(9 citation statements)

References 10 publications

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“…9,10,11 But it is also higher in comparison with that of other studies in other tertiary health centre of our country. 12,13,14 Being a tertiary health care centre, this high rate is not acceptable. The poor socioeconomic condition of the people of this area, delayed referral/transfer of the patient to the hospital and the deficient health infrastructure of this hospital may play a part to this high rate.…”

Section: Discussionmentioning

confidence: 99%

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Institutional Factors Affecting Maternal Mortality in a Teaching Hospital

Baby¹,

Shaha²

1970

J. Bangladesh Coll. Phys.

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Objective: To identify the institutional factors causing third delay of maternal mortality in Faridpur Medical College Hospital- a tertiary public health care centre in Bangladesh. Design: Cross-Sectional Study. Study period: January 2001 to December 2005. Methods and Materials: The case notes of all maternal deaths were reviewed at the end of each month during the study period. Various factors causing delay in the proper management of the cases were identified and noted. The data obtained from these reviews formed the basis of this study. Results: During the study period total 202 mothers died giving the maternal mortality 2010.5 per 100,000 deliveries. In 130(64.4%) cases one or more institutional factors were identified those contributed significantly to maternal deaths. The identified factors were: delayed blood transfusion or non availability of blood (40%); delayed or lack of operative interventions (37%); late or nonattendance by senior doctors (24.8%); operative interventions done by junior doctors (9.9%); non availability of ICU (intensive care unit) facility (29.7%) and of medicine (7.4%). Conclusion: There is a steady fall in maternal mortality ratio (MMR) in Bangladesh since 1990. But to reach the Millennium Development Goal for maternal health (MDG-5), the MMR will need to decrease at a much faster rate in the future. Improvement of the infrastructural facilities in the hospital can help to remove the preventable institutional factors causing third delay of maternal mortality. This can be a short term strategy to reduce maternal mortality. Key words: Maternal mortality; Institutional factor; Third delay. DOI: 10.3329/jbcps.v28i1.4636 J Bangladesh Coll Phys Surg 2010; 28: 5-9

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Section: Discussionmentioning

confidence: 99%

“…3,4,5,6,12,13,14 Different studies abroad also show the similar causes of maternal mortality. 15,16,17,18,19 In 64.4% cases of present study one or more contributing factors for maternal death were present.…”

Section: Discussionmentioning

confidence: 99%

Institutional Factors Affecting Maternal Mortality in a Teaching Hospital

Baby¹,

Shaha²

1970

J. Bangladesh Coll. Phys.

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“…However Government of Bangladesh has taken initiatives to establish perinatal death audit in different hospital since 2004. A decrease in overall mortality rates was recorded after introduction of perinatal mortality audit in LAMB Hospital of Bangladesh ( a NGO ) 5 . This glorious example should be an eye opening for the professionals , hospital managers and the planners for introducing death audit in a 'non blaming' atmosphere.…”

Section: Discussionmentioning

confidence: 99%

Death Audit An Experience In Medicine Ward

Mf¹,

Abedin²,

Uddin³

et al. 2015

J. Bangladesh Coll. Phys.

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Recently Directorate General of Health Services provided a circular to maintain death audit in every department of health sector (Public health-2/ESD-01/ information/2008/454). Death audit is important because it gives an understanding to what happens and why. This helps to go beyond rates and ratios to determine the inciting factors and to take measures how deaths could have been avoided7. This study was designed to find out relation between some factors like age, sex, causes, diurnal variation, duration of hospital stay with death pattern in adult medicine units, in a tertiary health facility and major error in death certification as described by WHO like mechanism of death listed without an underlying cause, improper sequencing of events and competing cause of death, minor errors like abbreviation, absence of time intervals and mechanism of death followed by underlying legitimate cause of death8 .Methodology: This was a cross-sectional study carried out in medicine department of Mitford hospital, Dhaka from March 2010 to August 2010. During this period a total of 100 consecutive deaths except those who were brought dead included in this study. Death certificate play a important role to make successful death audit. Our existing death certificate which is supplied by the government of Bangladesh was not adequate enough to fulfill the format of cause of death section based on the recommendation of the World Health Organization. More over our doctor are not trained enough for appropriate fulfillment of death certificate. Major errors are mechanism of death listed without an underlying cause, Improper sequencing, Competing cause and minor errors are using abbreviations, absence of time intervals, mechanism of death followed by underlying legitimate cause of death. Definition of major & minor errors in death certificate are shown in Table(I)). Ethical clearance was obtained from the concerned authority to conduct the research work. We used purposive non probability sampling for collection of cases. Our inclusion criteria was all death during study period & exclusion criteria was Brought dead. We developed a network with nurses, internee and midlevel doctors so that one of us could reach the hospital within half an hour of a death. After taking permission from hospital authority necessary data were collected from hospital case records, admission register, case files A checklist was designed to record profile of patients, time of admission, diagnosis at the time of admission , time of death and cause of death. Data were analyzed by SPSS where necessary.Results: During the study period a total 13,123 (Male-5249, 40%; Female-7874,60%) patients were admitted in the medicine department of Sir Salimullah Medical College (SSMC) and Mitford Hospital. Among them consecutive 100 deaths in medicine ward were analyzed under death audit. Among 100 deaths 48% were male(n=48) and 52% were female(n=52). The age range was 15-85 years. The highest incidence of death occurred in 56- 65 years group. This group represents 24% of total death. Within this group 66.7%(N=16) were male and 33.3%(N=8) were female. As shown in table (II).J Bangladesh Coll Phys Surg 2014; 32: 137-141

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“…A decrease in overall mortality rates was recorded after introduction of perinatal mortality audit in LAMB Hospital of Bangladesh (a NGO). 5 This glorious example should be an eye opening for the professionals, hospital managers and the planners for introducing death audit in a ‘nonblaming’ atmosphere.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Bangladesh has started maternal, neonatal and child death audit. 5 6 Death audit in other health sector especially in medicine department is not started yet. Recently, Director General of Health Services, Government of Bangladesh published a circular to maintain death audit in every department of health sector (Public health-2/ESD-01/ information/2008/454).…”

Section: Introductionmentioning

confidence: 99%

Chronic Liver Disease is One of the Leading Causes of Death in Bangladesh: Experience by Death Audit from a Tertiary Hospital

Hoque

Islam

et al. 2014

Euroasian Journal of Hepato-Gastroenterology

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Background In industrialized countries, the audit has become an integral part of medical care. The experience from developing countries like Bangladesh is still inadequate. This study had been carried out to find out relation among some factors like age, sex, causes, diurenal variation, duration of hospital stay with death and errors in certification process.Materials and methods It was a cross-sectional study conducted at the Department of Medicine, Sir Salimullah Medical College (SSMC) and Mitford Hospital from March 2010 to August 2010. Information of consecutive 100 deaths was collected in a predesigned clinical data sheet within half an hour of every occurrence. Necessary data were collected from hospital case records (admission registrar, case files and death certificates) using structured checklist. Patients who were brought dead were excluded from the study.Results Among 100 deaths, 48% were males (n = 48) and 52% were females (n = 52). Within this group, 66.7% were males and 33.3% were females. First day (within 24 hours of admission) death accounted for 46% (n = 46) of all death and by the second day 23% (n = 23) of all deaths occurred. The highest underlying cause of death was cerebrovascular diseases (29% of total death), infectious disease contributed 20%, chronic liver disease 13%, malignancy 7%, poisoning 6%, cor pulmonale 5%, while others were 20%.Conclusion In this studychronic liver disease was found to be one of the leading causes of death in our hospital and most of them occurred due to hepatic encephalopathy. So, early detection of hepatic encephalopathy and treatment is necessary to reduce hospital mortality.How to cite this article: Abedin MF, Hoque MM, Islam ASMS, Chowdhury MFI, Das DC, Begum SA, Mamun AA, Mahtab MA, Rahman S, Saha AK. Chronic Liver Disease is One of the Leading Causes of Death in Bangladesh: Experience by Death Audit from a Tertiary Hospital. Euroasian J Hepato-Gastroenterol 2014;4(1):14-17.

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Maternal Death Audit: Experience from a Periurban Hospital

Cited by 4 publications

References 10 publications

Institutional Factors Affecting Maternal Mortality in a Teaching Hospital

Institutional Factors Affecting Maternal Mortality in a Teaching Hospital

Death Audit An Experience In Medicine Ward

Chronic Liver Disease is One of the Leading Causes of Death in Bangladesh: Experience by Death Audit from a Tertiary Hospital

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Maternal Death Audit: Experience from a Periurban Hospital

Cited by 4 publications

References 10 publications

Institutional Factors Affecting Maternal Mortality in a Teaching Hospital

Institutional Factors Affecting Maternal Mortality in a Teaching Hospital

Death Audit An Experience In Medicine Ward

Chronic Liver Disease is One of the Leading Causes of Death in Bangladesh: Experience by Death Audit from a Tertiary Hospital

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Death Audit An Experience In Medicine Ward