Confidential Enquiry into Maternal Deaths in Namibia, 2018–2019: A Local Approach to Strengthen the Review Process and a Description of Review Findings and Recommendations
-
Published:2023-09-30
Issue:12
Volume:27
Page:2165-2174
-
ISSN:1092-7875
-
Container-title:Maternal and Child Health Journal
-
language:en
-
Short-container-title:Matern Child Health J
Author:
Heemelaar SteffieORCID, Callard BeatrixORCID, Shikwambi Hilma, Ellmies Jana, Kafitha Wilhelmina, Stekelenburg JelleORCID, van den Akker ThomasORCID, Mackenzie ShonagORCID
Abstract
Abstract
Objectives
First objective was to strengthen the national maternal death review, by addressing local challenges with each step of the review cycle. Second objective was to describe review findings and compare these with available findings of previous reviews.
Methods
Confidential Enquiry into Maternal Deaths methodology was used to review maternal deaths. To improve reporting, the national committee focussed on addressing fear of blame among healthcare providers. Second focus was on dissemination of findings and acting on recommendations forthcoming the review. Reviewed were reported maternal deaths, that occurred between 1 April 2018 and 31 March 2019.
Results
Seventy maternal deaths were reported; for 69 (98.6%) medical records were available, compared to 80/119 (67.2%) in 2012–2015. Reported maternal mortality ratio increased with 48% (92/100,000 live births compared to 62/100,000 in 2012–2015). Obstetric haemorrhage was leading cause of death in the past three reviews. The “no name, no blame” policy, aiming to identify health system failures, rather than mistakes of individuals, was repeatedly explained to healthcare providers during facility visits. Recommendations based on findings of the review, such as retaining experienced staff, continuous in-service training and guidance, were shared with decision makers at regional and national levels. Healthcare providers received training based on review findings, which resulted in improved management of similar cases.
Conclusions for Practice
Enhanced implementation of Confidential Enquiry into Maternal Deaths was possible after addressing local challenges. Focussing on obtaining trust of healthcare providers and feeding back findings, resulted in better reporting and prevention of potential maternal deaths.
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health,Obstetrics and Gynecology,Pediatrics, Perinatology and Child Health,Epidemiology
Reference35 articles.
1. Creanga, A. (2017). Maternal mortality in the developed world: A review of surveillance methods, levels and causes of maternal deaths during 2006–2010. Minerva Ginecologica, 69(6), 608–617. 2. Geingob, H. (2016). Harambee Prosperity Plan. Goverment document. Office of the President. Retrieved January 19, 2020, from http://www.nied.edu.na/assets/documents/08Governments/13HPP_page_70-71.pdf 3. Heemelaar, S., Josef, M., Diener, Z., Chipeio, M., Stekelenburg, J., van den Akker, T., et al. (2020). Maternal near-miss surveillance, Namibia. Bulletin of the World Health Organization, 98(8), 548–557. 4. Hodorogea, S., & Friptu, V. (2014). The Moldovan experience of maternal death reviews. British Journal of Obstetrics and Gynaecology, 121(Suppl 4), 81–85. 5. Jayakody, H., & Knight, M. (2020). Implementation assessment in confidential enquiry programmes: A scoping review. Paediatric and Perinatal Epidemiology, 34(4), 399–407.
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|