Establishment of a Maternal Newborn Health Registry in the Belgaum District of Karnataka, India.
Establishment of a Maternal Newborn Health Registry in the Belgaum District of Karnataka, India.
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DOI：
10.1186/1742-4755-12-s2-s3
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发表时间：
2015
影响因子：
3.4
通讯作者：
Goldenberg RL
中科院分区：
文献类型：
--
作者：
Kodkany BS;Derman RJ;Honnungar NV;Tyagi NK;Goudar SS;Mastiholi SC;Moore JL;McClure EM;Sloan N;Goldenberg RL
与怀孕有关的人口动态登记对于为降低孕产妇、胎儿和新生儿死亡率的政策提供信息十分重要，但在大多数死亡发生的中低收入国家，几乎没有获取准确数据的系统。此外，还没有描述有效实现高质量配准系统的方法。创建本文所述登记处的目的是告知公共卫生政策制定者在我区的妊娠结局，以便采取适当的干预措施，以改善这些结果，并将该地区定位为妊娠相关公共卫生研究的领导者。我们在印度卡纳塔克邦的贝尔高姆建立了一个前瞻性的孕产妇和新生儿健康登记处。为了启动这一登记，我们与卫生部合作，首先确定了估计的出生率，并在现有的卫生系统和初级卫生中心内确定了集群的覆盖范围。我们还进行了家庭调查，以确定可能怀孕的妇女。然后，我们实施了监测措施，以确保孕产妇和新生儿健康登记册的高质量和完整性。在怀孕期间，对集水区的所有孕妇进行了识别、同意和登记，并进行了随访访视，以确定产后42天的妊娠结局和母婴状态。从2008年到2014年，我们证明了在印度贝尔高姆定义的集水区内，招募覆盖率和报告妊娠结局的准确性都在持续改善。近100%的妇女在出生时接受了随访，99%的妇女接受了42天的随访。此外，我们促进了妊娠期女性的早期入组，同时实现了更及时的随访，并缩短了自妊娠事件发生之日起的报告时间。我们创建了一个怀孕相关的登记处，其中包括人口统计数据，风险因素和结果，允许在现有卫生系统内工作时进行高比例的确定和随访。了解用于创建注册表的系统的要素对于提高结果的质量非常重要。跟踪怀孕及其结果是降低孕产妇和围产期死亡率的重要一步。
Pregnancy-related vital registration is important to inform policy to reduce maternal, fetal and newborn mortality, yet few systems for capturing accurate data are available in low-middle income countries where the majority of the mortality occurs. Furthermore, methods to effectively implement high-quality registration systems have not been described. The goal of creating the registry described in this paper was to inform public health policy makers about pregnancy outcomes in our district so that appropriate interventions to improve these outcomes could be undertaken and to position the district to be a leader in pregnancy-related public health research. We created a prospective maternal and newborn health registry in Belgaum, Karnataka State, India. To initiate this registry, we worked with the Ministry of Health to first establish estimated birth rates and define the catchment areas of the clusters, working within the existing health system and primary health centers. We also undertook household surveys to identify women likely to become pregnant. We then implemented monitoring measures to ensure high quality and completeness of the maternal newborn health registry. All pregnant women in the catchment area were identified, consented and enrolled during pregnancy, with follow-up visits to ascertain pregnancy outcomes and mother/infant status at 42-days postpartum. From 2008 through 2014, we demonstrated continued improvements in both the coverage for enrollment and accuracy of reporting pregnancy outcomes within the defined catchment area in Belgaum, India. Nearly 100% of women enrolled had follow-up at birth and 99% had 42-day follow-up. Furthermore, we facilitated earlier enrollment of women during pregnancy while achieving more timely follow-up and decreased time of reporting from the date of the pregnancy event. We created a pregnancy-related registry which includes demographic data, risk factors, and outcomes allowing for high rates of ascertainment and follow-up while working within the existing health system. Understanding the elements of the system used to create the registry is important to improve the quality of the results. Tracking of pregnancies and their outcomes is an important step toward reducing maternal and perinatal mortality.