Maternal mortality in Senegal

Dumont, Alexandre

doi:10.2471/blt.05.023903

Cited by 55 publications

(16 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In places where establishment of maternal mortality audits has led to improved quality of obstetric care, the success has been particularly attributed to strong leadership and accountability of both health providers and key decision makers [7,11,25,26]. Our findings recommend a more responsive health system from the level of the ministry of health down to the grass root levels.…”

Section: Discussionmentioning

confidence: 81%

Using audit to enhance quality of maternity care in resource limited countries: lessons learnt from rural Tanzania

Nyamtema

Jong

Urassa

et al. 2011

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

BackgroundAlthough clinical audit is an important instrument for quality care improvement, the concept has not yet been adequately taken on board in rural settings in most resource limited countries where the problem of maternal mortality is immense. Maternal mortality and morbidity audit was established at Saint Francis Designated District Hospital (SFDDH) in rural Tanzania in order to generate information upon which to base interventions.MethodsMethods are informed by the principles of operations research. An audit system was established, all patients fulfilling the inclusion criteria for maternal mortality and severe morbidity were reviewed and selected cases were audited from October 2008 to July 2010. The causes and underlying factors were identified and strategic action plans for improvement were developed and implemented.ResultsThere were 6572 deliveries and 363 severe maternal morbidities of which 36 women died making institutional case fatality rate of 10%. Of all morbidities 341 (94%) had at least one area of substandard care. Patients, health workers and administration related substandard care factors were identified in 50% - 61% of women with severe morbidities. Improving responsiveness to obstetric emergencies, capacity building of the workforce for health care, referral system improvement and upgrading of health centres located in hard to reach areas to provide comprehensive emergency obstetric care (CEmOC) were proposed and implemented as a result of audit.ConclusionsOur findings indicate that audit can be implemented in rural resource limited settings and suggest that the vast majority of maternal mortalities and severe morbidities can be averted even where resources are limited if strategic interventions are implemented.

show abstract

Section: Discussionmentioning

confidence: 81%

Using audit to enhance quality of maternity care in resource limited countries: lessons learnt from rural Tanzania

Nyamtema

Jong

Urassa

et al. 2011

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…The situation has been found to be similar in India, where a maternal death review at the community level is vital in making maternal deaths more visible to community members and policy-makers [12]. Many African countries also undertake maternal death reviews at facility level [24]. One African study concluded that facility-based MDR can be combined with community verbal autopsies.…”

Section: Discussionmentioning

confidence: 99%

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

Biswas¹,

Rahman²,

Halim³

et al. 2014

Health

View full text Add to dashboard Cite

Objectives: To identify the effects of Maternal and Neonatal Death Review (MNDR) in terms of improving maternal and neonatal health at the community level in Bangladesh. Methods: Both quantitative and qualitative methods were undertaken for collecting data in Kashipur Union, Bangladesh. Death notifications from households, subsequent data collections from a focus-group discussion (FGD), a group discussion (GD) and in-depth interviews (IDIs) were obtained using structured tools and guidelines. Results: A total of four maternal deaths, 21 neonatal deaths and 15 still births were reported in the MNDR death notification system at Kashipur Union in 2010. Data were presented to local programme managers, who took various initiatives including awareness programmes, pregnancy registration, antenatal care, birth planning, and also the revitalization of a community clinic. The coverage of antenatal care, delivery in clinics, postnatal care and referral of complications increased through the active participation of the community. Community healthcare providers, care recipients and members of the community expressed satisfaction with the quality of maternal and neonatal services. In the preceding two years, maternal and neonatal deaths substantially reduced in Kashipur (in 2011 maternal death = 1, neonatal death = 20, still birth = 8; in 2012 maternal death = 1, neonatal death = 8, still birth = 13). Conclusions: The MNDR system successfully delivered notification of all maternal and neonatal deaths in the defined area and collected information for the formulation and implementation of specific interventions, which resulted in visible and tangible changes in care-seeking and client satisfaction.

show abstract

“…Previous studies have shown that recommendations resulting from the audit sessions were poorly implemented because of a lack of human and material resources and insufficient staff and senior management commitment [ 13 , 14 ]. Conversely, in other studies where recommendations were implemented and evaluated, reductions in maternal mortality, the case fatality rate [ 50 , 51 ], the incidence of uterine rupture, obstetric hemorrhage and the number of women with severe maternal complications were observed [ 52 , 53 ].…”

Section: Discussionmentioning

confidence: 99%

Easier said than done!: methodological challenges with conducting maternal death review research in Malawi

Thorsen

Sundby

Meguid

et al. 2014

BMC Med Res Methodol

View full text Add to dashboard Cite

BackgroundMaternal death auditing is widely used to ascertain in-depth information on the clinical, social, cultural, and other contributing factors that result in a maternal death. As the 2015 deadline for Millennium Development Goal 5 of reducing maternal mortality by three quarters between 1990 and 2015 draws near, this information becomes even more critical for informing intensified maternal mortality reduction strategies. Studies using maternal death audit methodologies are widely available, but few discuss the challenges in their implementation. The purpose of this paper is to discuss the methodological issues that arose while conducting maternal death review research in Lilongwe, Malawi.MethodsCritical reflections were based on a recently conducted maternal mortality study in Lilongwe, Malawi in which a facility-based maternal death review approach was used. The five-step maternal mortality surveillance cycle provided the framework for discussion. The steps included: 1) identification of cases, 2) data collection, 3) data analysis, 4) recommendations, and 5) evaluation.ResultsChallenges experienced were related to the first three steps of the surveillance cycle. They included: 1) identification of cases: conflicting maternal death numbers, and missing medical charts, 2) data collection: poor record keeping, poor quality of documentation, difficulties in identifying and locating appropriate healthcare workers for interviews, the potential introduction of bias through the use of an interpreter, and difficulties with locating family and community members and recall bias; and 3) data analysis: determining the causes of death and clinical diagnoses.ConclusionConducting facility-based maternal death reviews for the purpose of research has several challenges. This paper illustrated that performing such an activity, particularly the data collection phase, was not as easy as conveyed in international guidelines and in published studies. However, these challenges are not insurmountable. If they are anticipated and proper steps are taken in advance, they can be avoided or their effects minimized.

show abstract

Maternal mortality in Senegal

Cited by 55 publications

References 18 publications

Using audit to enhance quality of maternity care in resource limited countries: lessons learnt from rural Tanzania

Using audit to enhance quality of maternity care in resource limited countries: lessons learnt from rural Tanzania

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

Easier said than done!: methodological challenges with conducting maternal death review research in Malawi

Contact Info

Product

Resources

About