Counting every stillbirth and neonatal death through mortality audit to improve quality of care for every pregnant woman and her baby

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dc.contributor.authorKerber, Katherine Jen_ZA
dc.contributor.authorMathai, Matthewsen_ZA
dc.contributor.authorLewis, Gwynethen_ZA
dc.contributor.authorFlenady, Vickien_ZA
dc.contributor.authorErwich, Jan Jaapen_ZA
dc.contributor.authorSegun, Tundeen_ZA
dc.contributor.authorAliganyira, Patricken_ZA
dc.contributor.authorAbdelmegeid, Alien_ZA
dc.contributor.authorAllanson, Emmaen_ZA
dc.contributor.authorRoos, Nathalieen_ZA
dc.contributor.authorRhoda, Natashaen_ZA
dc.contributor.authorLawn, Joyen_ZA
dc.contributor.authorPattinson, Roberten_ZA
dc.date.accessioned2015-12-07T08:52:38Z
dc.date.available2015-12-07T08:52:38Z
dc.date.issued2015en_ZA
dc.description.abstractBACKGROUND: While there is widespread acknowledgment of the need for improved quality and quantity of information on births and deaths, there has been less movement towards systematically capturing and reviewing the causes and avoidable factors linked to deaths, in order to affect change. This is particularly true for stillbirths and neonatal deaths which can fall between different health care providers and departments. Maternal and perinatal mortality audit applies to two of the five objectives in the Every Newborn Action Plan but data on successful approaches to overcome bottlenecks to scaling up audit are lacking. METHODS: We reviewed the current evidence for facility-based perinatal mortality audit with a focus on low- and middle-income countries and assessed the status of mortality audit policy and implementation. Based on challenges identified in the literature, key challenges to completing the audit cycle and affecting change were identified across the WHO health system building blocks, along with solutions, in order to inform the process of scaling up this strategy with attention to quality. RESULTS: Maternal death surveillance and review is moving rapidly with many countries enacting and implementing policies and with accountability beyond the single facility conducting the audits. While 51 priority countries report having a policy on maternal death notification in 2014, only 17 countries have a policy for reporting and reviewing stillbirths and neonatal deaths. The existing evidence demonstrates the potential for audit to improve birth outcomes, only if the audit cycle is completed. The primary challenges within the health system building blocks are in the area of leadership and health information. Examples of successful implementation exist from high income countries and select low- and middle-income countries provide valuable learning, especially on the need for leadership for effective audit systems and on the development and the use of clear guidelines and protocols in order to ensure that the audit cycle is completed. CONCLUSIONS: Health workers have the power to change health care routines in daily practice, but this must be accompanied by concrete inputs at every level of the health system. The system requires data systems including consistent cause of death classification and use of best practice guidelines to monitor performance, as well as leaders to champion the process, especially to ensure a no-blame environment, and to access change agents at other levels to address larger, systemic challenges.en_ZA
dc.identifier.apacitationKerber, K. J., Mathai, M., Lewis, G., Flenady, V., Erwich, J. J., Segun, T., ... Pattinson, R. (2015). Counting every stillbirth and neonatal death through mortality audit to improve quality of care for every pregnant woman and her baby. <i>BMC Pregnancy and Childbirth</i>, http://hdl.handle.net/11427/15659en_ZA
dc.identifier.chicagocitationKerber, Katherine J, Matthews Mathai, Gwyneth Lewis, Vicki Flenady, Jan Jaap Erwich, Tunde Segun, Patrick Aliganyira, et al "Counting every stillbirth and neonatal death through mortality audit to improve quality of care for every pregnant woman and her baby." <i>BMC Pregnancy and Childbirth</i> (2015) http://hdl.handle.net/11427/15659en_ZA
dc.identifier.citationKerber, K. J., Mathai, M., Lewis, G., Flenady, V., Erwich, J. J. H., Segun, T., ... & Pattinson, R. (2015). Counting every stillbirth and neonatal death through mortality audit to improve quality of care for every pregnant woman and her baby. BMC pregnancy and childbirth, 15(Suppl 2), S9.en_ZA
dc.identifier.ris TY - Journal Article AU - Kerber, Katherine J AU - Mathai, Matthews AU - Lewis, Gwyneth AU - Flenady, Vicki AU - Erwich, Jan Jaap AU - Segun, Tunde AU - Aliganyira, Patrick AU - Abdelmegeid, Ali AU - Allanson, Emma AU - Roos, Nathalie AU - Rhoda, Natasha AU - Lawn, Joy AU - Pattinson, Robert AB - BACKGROUND: While there is widespread acknowledgment of the need for improved quality and quantity of information on births and deaths, there has been less movement towards systematically capturing and reviewing the causes and avoidable factors linked to deaths, in order to affect change. This is particularly true for stillbirths and neonatal deaths which can fall between different health care providers and departments. Maternal and perinatal mortality audit applies to two of the five objectives in the Every Newborn Action Plan but data on successful approaches to overcome bottlenecks to scaling up audit are lacking. METHODS: We reviewed the current evidence for facility-based perinatal mortality audit with a focus on low- and middle-income countries and assessed the status of mortality audit policy and implementation. Based on challenges identified in the literature, key challenges to completing the audit cycle and affecting change were identified across the WHO health system building blocks, along with solutions, in order to inform the process of scaling up this strategy with attention to quality. RESULTS: Maternal death surveillance and review is moving rapidly with many countries enacting and implementing policies and with accountability beyond the single facility conducting the audits. While 51 priority countries report having a policy on maternal death notification in 2014, only 17 countries have a policy for reporting and reviewing stillbirths and neonatal deaths. The existing evidence demonstrates the potential for audit to improve birth outcomes, only if the audit cycle is completed. The primary challenges within the health system building blocks are in the area of leadership and health information. Examples of successful implementation exist from high income countries and select low- and middle-income countries provide valuable learning, especially on the need for leadership for effective audit systems and on the development and the use of clear guidelines and protocols in order to ensure that the audit cycle is completed. CONCLUSIONS: Health workers have the power to change health care routines in daily practice, but this must be accompanied by concrete inputs at every level of the health system. The system requires data systems including consistent cause of death classification and use of best practice guidelines to monitor performance, as well as leaders to champion the process, especially to ensure a no-blame environment, and to access change agents at other levels to address larger, systemic challenges. DA - 2015 DB - OpenUCT DO - 10.1186/1471-2393-15-S2-S9 DP - University of Cape Town J1 - BMC Pregnancy and Childbirth LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - Counting every stillbirth and neonatal death through mortality audit to improve quality of care for every pregnant woman and her baby TI - Counting every stillbirth and neonatal death through mortality audit to improve quality of care for every pregnant woman and her baby UR - http://hdl.handle.net/11427/15659 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15659
dc.identifier.urihttp://dx.doi.org/10.1186/1471-2393-15-S2-S9
dc.identifier.vancouvercitationKerber KJ, Mathai M, Lewis G, Flenady V, Erwich JJ, Segun T, et al. Counting every stillbirth and neonatal death through mortality audit to improve quality of care for every pregnant woman and her baby. BMC Pregnancy and Childbirth. 2015; http://hdl.handle.net/11427/15659.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDepartment of Paediatrics and Child Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2015 Kerber et al.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourceBMC Pregnancy and Childbirthen_ZA
dc.source.urihttp://www.biomedcentral.com/bmcpregnancychildbirth/en_ZA
dc.subject.otherHealthworkeren_ZA
dc.subject.othermedical auditen_ZA
dc.subject.othermaternalen_ZA
dc.subject.othermidwivesen_ZA
dc.subject.othermortalityen_ZA
dc.subject.otherneonatal deathen_ZA
dc.subject.otherstillbirthen_ZA
dc.subject.otherquality of careen_ZA
dc.titleCounting every stillbirth and neonatal death through mortality audit to improve quality of care for every pregnant woman and her babyen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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