Maternal death review and surveillance: The case of Central Hospital, Benin City, Nigeria
Autoři:
Josephine Aikpitanyi aff001; Victor Ohenhen aff002; Philip Ugbodaga aff003; Best Ojemhen aff001; Blessing I. Omo-Omorodion aff001; Lorretta FC Ntoimo aff001; Wilson Imongan aff001; Joseph A. Balogun aff005; Friday E. Okonofua aff001
Působiště autorů:
The Women’s Health and Action Research Centre (WHARC), Benin City, Nigeria
aff001; The Centre of Excellence in Reproductive Health Innovation (CERHI), University of Benin, Benin City, Nigeria
aff002; The Central Hospital, Benin City, Nigeria
aff003; The Federal University, Oye-Ekiti, Nigeria
aff004; The University of Medical Sciences, Ondo City, Ondo State, Nigeria
aff005; Chicago State University, Chicago, United States of America
aff006
Vyšlo v časopise:
PLoS ONE 14(12)
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pone.0226075
Souhrn
Background
Despite the adoption of Maternal and Perinatal Death Surveillance and Response (MPDSR) by Nigeria’s Federal Ministry of Health to track and rectify the causes of maternal mortality, very limited documentation exists on experiences with the method and its outcomes at institutional and policy levels.
Objective
The objective of this study was to identify through the MPDSR process, the medical causes and contributory factors of maternal mortality, and to elucidate the policy response that took place after the dissemination of the results.
Methods
The study was conducted at the Central Hospital, Benin between October 1, 2017, and May 31, 2019. We first developed a strategic plan with the objective to reduce maternal mortality by 50% in the hospital in two years. An MPDSR committee was established and the members and all staff of the Maternity Department of the hospital were trained to use the nationally approved protocol. All consecutive cases of maternal deaths in the hospital were then reviewed using the MPDSR protocol. The results were submitted to the hospital Management and its supporting agencies for administrative action to correct the identified deficiencies.
Results
There were 18 maternal deaths in the hospital during the period, and 4,557 deliveries giving a maternal mortality ratio (MMR) of 395/100,000 deliveries. This amounted to a seven-fold reduction in MMR in the hospital at the onset of the project. The main medical causes identified were obstetric hemorrhage (n = 10), pulmonary embolism (n = 2), ruptured uterus (n = 2), eclampsia (n = 1), anemic heart failure (n = 1) and post-partum sepsis (n = 2). Several facility-based and patient contributory factors were identified such as lack of blood in the hospital and late reporting with severe obstetric complication among others. Response to the recommendations from the committee include increased commitment of hospital managers to immediately rectify the attributable causes of deaths, the establishment of a couples health education program, mobilization and sensitization of staff to handle pregnant women with great sensitivity, promptness and care, the refurbishing of an intensive care unit, and the increased availability of blood for transfusion through the intensification of blood donation drive in the hospital.
Conclusion
We conclude that the results of MPDSR, when acted upon by hospital managers and policymakers can lead to an improvement in quality of care and a consequent decline in maternal mortality ratio in referral hospitals.
Klíčová slova:
Death rates – Critical care and emergency medicine – Hospitals – Labor and delivery – Obstetrics and gynecology – Pregnancy – Blood – Benin
Zdroje
1. World Health Organization. Beyond the numbers: Reviewing maternal deaths and complications to make pregnancy safer. 2004. www.who.int/documents (accessed 12th August, 2019).
2. World Health Organization. Maternal death surveillance and response: technical guidance information for action to prevent maternal death. 2013. www.who.int/maternalchildadolescents/documents/maternal_death_surveillance/en (accessed 6th June, 2019).
3. World Health Organization. Trends in maternal mortality: 1990 to 2015: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. 2015. www.unfpa.org/publications (accessed 6th June, 2019).
4. Hussein J, Hirose A, Oluwatoyin O, Mari I, Lovney K, Okonofua F. Maternal death and obstetric care audits in Nigeria: a systematic review of barriers and enabling factors in the provision of emergency care. Reprod. Health. 2016; (13):47 doi: 10.1186/s12978-016-0158-4 27102983
5. Sageer R, Kongnyuy E, Olalekan WA, Omosehin O, Elijah AO, Bola S. Causes and contributory factors of maternal and perinatal deaths surveillance and response in Ogun State, Southwest Nigeria. BMC Pregnancy and Childbirth. 2019; (19):63 doi: 10.1186/s12884-019-2202-1 30744576
6. Hofman J, Mohammed H. Experiences with facility-based maternal death reviews in northern Nigeria. Int. J. Gynecol. Obstet. 2014; (126):111–114 doi: 10.1016/j.ijgo.2014.02.014
7. Okonofua F, Imosemi D, Igboin B, Adeyemi A, Chibuko C, Idowu A, et al. Maternal death review and outcomes: An assessment in Lagos State, Nigeria. PLoS ONE 2017; 12(12): e0188392. doi: 10.1371/journal.pone.0188392 29240754
8. Ntiomo L, Okonofua FE, Gana M, Ogu R., Abdus-salam A, Galadanci H., et al. A. Prevalence and risk factors for maternal mortality in Nigerian referral hospitals. Int J Women’s Health 2018; (10): 69–76. doi: 10.2147/IFWH.S151784 29440934.
9. Singh K, Puri S, Chopra G. Maternal Mortality in India: An Overview of Social Causes. IJSR. 2018; (8):3, ISSN 2250-3153
10. Teka H, Yibrah BZ. A 3 years review of maternal death and associated factors at Ayder Comprehensive Specialized Hospital, Northern Ethiopia. Ethiop J Reprod Health. 2018; (10):3
11. Dumont A, Gaye A, De Bernis L, Chaillet N, Landry A, Delage J et al. Facility-based maternal death reviews: effects on maternal mortality in a district hospital in Senegal. Bulletin of the World Health Organization | March 2006, (84):3
12. Mpumelelo M, Tsitsi P, Juru N, Mungati M, Gombe N, Peter N, et al. Evaluation of the Maternal Death Surveillance and response system in Hwange District, Zimbabwe. BMC Pregnancy and Childbirth. 2019; (19):103 https://doi.org/10.1186/s12884-019-2255-1
13. Hounton S, De Bernis L, Hussein J, Graham W, Danel I, Byass P. et al. Towards elimination of maternal deaths: maternal deaths surveillance and response. Reprod. Health. 2013; (10):1
14. Lusambili A, Jepkosgei J, Nzinga J, English M. "What do we know about maternal and perinatal mortality and morbidity audits in sub-Saharan Africa? A scoping literature review", Intern J of Hum Rights in Healthcare. 2019;12(3):192–207 https://doi.org/10.1108/IJHRH-07-2018-0052
15. Kanika PK, Mahima J. A Study of Causes and Factors Responsible for Maternal Mortality in a Tertiary Care Institute of Central Gujarat. J. Gynecol. Obstet. 2019; 7(4):100–103. doi: 10.11648/j.jgo.20190704.11
16. Bandali S, Camille T, Eleanor H, Zoe M, Matthews M, Thandassery RD et al. Maternal Death Surveillance and Response in driving accountability and influencing change. Int. J. Gynecol. Obstet. 2016; (135):365–371
17. Hounkpatin B, Obossou AAA, Aguemon CT, Hounkponou FN, Aboubakar M, Sehlouan C, et al. The Impact of Audits of Maternal Deaths and Near Miss at University Hospital of Mother and Child Lagoon (Benin). Clinics Mother Child Health. 2016; (13):1. doi: 10.4172/2090-7214.1000218
18. Coulibaly KSA, Kourouma KR, Doukoure D, Agbre Y, Marie L, Aka O. Maternal death reviews in the health region of Agneby-Tiassa-Me in Cote d’Ivoire from January to December 2016: a cross-sectional retrospective analysis. IJMSCI. 2018; 5(12):4223–4228 doi: 10.18535/ijmsci/v5i12.05
19. Kongnyuy EJ, Nynke VB. The difficulties of conducting maternal death reviews in Malawi. BMC Pregnancy and Childbirth. 2008; (8):42 doi: 10.1186/147-2393-8-42
20. Matthews M, Thandassery RD, Issrah J, Sachiyo Y. Strengthening accountability to end preventable maternal deaths. Int. J. Gynecol. Obstet. 2015; (131): s3 –s5 doi: 10.1016/j.ijgo.2015.02.012 26433501
21. Tamba MM, Sidikiba S, Alexandre D, Kefilath OA, Basile K et at. Evaluation of the maternal deaths surveillance and response system at the district level in Guinea in 2017 through digital communication tools. Reprod. Health. 2019; (16):5 doi: 10.1186/s12978-019-0671-3 30658674
22. Samuel H, Fikre E, Yemane B. Health facility-based maternal death audit in Tigray, Ethiopia. Ethiop J Health Dev. 2009; 23(2):115–119 doi: 10.4314/ejhd.v23i2.63226
23. Helen S, Charls A, Natalie R, Matthews M, Nynke VB. Implementing maternal death surveillance and response: a review of lessons from country case studies. BMC Pregnancy and Childbirth. 2017; (17):233, doi: 10.1186/s12884-017-1405-6 28716124
24. Uzabakiriho B, Maswime S. Causes of maternal death at Natalspruit Hospital, Johannesburg, South Africa. S Afr Med J. 2019; 109(6):13215
25. Federal Ministry of Health Abuja, National Guidelines for Maternal Perinatal Death Surveillance and Response in Nigeria. March 2015
26. Knight HE; Self A; Kennedy SH. Why are women dying when they reach hospital on time? A systematic review of the ‘third delay’. PLoS One. 2013; 8 (5): e63846. ISSN 1932-6203 doi: 10.1371/journal.pone.0063846 23704943
27. The WHO Application of ICD-10 to deaths during pregnancy, childbirth and the puerperium: ICD-MM. 2012; www.who.int/ICD_10_SMoL (accessed 12th August, 2019).
28. Lachmi RK, Verschueren K, Roosmalen JV, Humphrey HH, Kitty WM. Maternal mortality audit in Suriname between 2010 and 2014, a reproductive age mortality survey. BMC Pregnancy and Childbirth. 2017; (17):275 doi: 10.1186/s12884-017-1466.6 28851302
29. Mohammad B, Dwirani A, Stephanie S, Ary K, Mohammad HS, Benjamin E. Maternal death reviews: A retrospective case series of 90 hospital-based maternal deaths in 11 hospitals in Indonesia. Int. J. Gynecol. Obstet. 2019; 144 (Suppl. 1): 59–64 doi: 10.1002/ijgo.12736 30815870
30. Okonofua F, Randawa A, Ogu R, Agholor K, Okike O, Abdus-salam RA, et al. Views of senior health personnel about quality of emergency obstetric care: A qualitative study in Nigeria. PLoS ONE. 2017; 12(3): e0173414. doi: 10.1371/journal.pone.0173414 28346519
Článok vyšiel v časopise
PLOS One
2019 Číslo 12
- Metamizol jako analgetikum první volby: kdy, pro koho, jak a proč?
- Nejasný stín na plicích – kazuistika
- Masturbační chování žen v ČR − dotazníková studie
- Těžké menstruační krvácení může značit poruchu krevní srážlivosti. Jaký management vyšetření a léčby je v takovém případě vhodný?
- Fixní kombinace paracetamol/kodein nabízí synergické analgetické účinky
Najčítanejšie v tomto čísle
- Methylsulfonylmethane increases osteogenesis and regulates the mineralization of the matrix by transglutaminase 2 in SHED cells
- Oregano powder reduces Streptococcus and increases SCFA concentration in a mixed bacterial culture assay
- The characteristic of patulous eustachian tube patients diagnosed by the JOS diagnostic criteria
- Parametric CAD modeling for open source scientific hardware: Comparing OpenSCAD and FreeCAD Python scripts