Implementation of maternal and perinatal death surveillance and response (MPDSR) in humanitarian settings: insights and experiences of humanitarian health practitioners and global technical expert meeting attendees.
Implementation of maternal and perinatal death surveillance and response (MPDSR) in humanitarian settings: insights and experiences of humanitarian health practitioners and global technical expert meeting attendees.
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DOI：
10.1186/s13031-022-00440-6
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发表时间：
2022-05-07
影响因子：
3.6
通讯作者：
Moran, Allisyn C.
中科院分区：
文献类型：
--
作者：
Russell, Neal;Tappis, Hannah;Mwanga, Jean Paul;Black, Benjamin;Thapa, Kusum;Handzel, Endang;Scudder, Elaine;Amsalu, Ribka;Reddi, Jyoti;Palestra, Francesca;Moran, Allisyn C.
孕产妇和围产期死亡监测和应对是一个查明、分析此类死亡并从中吸取经验教训的系统，以应对和预防未来的死亡，近年来得到世卫组织的建议并在许多中低收入环境中实施。然而，关于在人道主义环境中使用MPDSR的经验的文献有限。世卫组织、联合国儿童基金会、疾病预防控制中心和救助儿童会、联合国人口基金和联合国难民署于2019年10月17日至18日召开了一次人道主义环境下的MPDSR会议，并通过对包括专家与会者在内的一系列专业人士的半结构化访谈提供了信息。受访者透露，在人道主义背景下充分执行《多学科发展战略》进程面临重大障碍。许多障碍在一般的低资源环境中是常见的，但在人道主义危机的背景下被放大，如负担过重的服务，报告的抑制因素，问责制差距，指责方法和死亡率政治化。人道主义背景下更为独特的因素包括对保健工作者安全和道德压力的关切。人道主义组织内的《人道主义和社会发展战略》的制度化和执行能力各不相同。有人建议，如果执行不力，特别是采用惩罚或指责的方法，MPDSR可能会适得其反。尽管如此，人们描述了MPDSR的成功之处，即这一进程导致采取了预防死亡的具体行动，死亡审查使人们更好地了解了在人道主义环境中导致死亡的复杂和可纠正的背景因素。尽管存在这些挑战，但仍有一些实例表明，从MPDSR进程中吸取的经验教训改善了人道主义背景下的护理机会和质量，包括成功的宣传。需要采取一种经过调整的办法，以确保可行性，在危机的不同阶段可以采取不同的执行办法。有必要在人道主义背景下提供关于多学科发展和社会责任的指导，并提供更多的文件和经验教训。在线版本包含补充材料，可通过10.1186/s13031-022-00440-6获得。
Maternal and perinatal death surveillance and response (MPDSR) is a system of identifying, analysing and learning lessons from such deaths in order to respond and prevent future deaths, and has been recommended by WHO and implemented in many low-and-middle income settings in recent years. However, there is limited documentation of experience with MPDSR in humanitarian settings. A meeting on MPDSR in humanitarian settings was convened by WHO, UNICEF, CDC and Save the Children, UNFPA and UNHCR on 17th–18th October 2019, informed by semi-structured interviews with a range of professionals, including expert attendees. Interviewees revealed significant obstacles to full implementation of the MPDSR process in humanitarian settings. Many obstacles were familiar to low resource settings in general but were amplified in the context of a humanitarian crisis, such as overburdened services, disincentives to reporting, accountability gaps, a blame approach, and politicisation of mortality. Factors more unique to humanitarian contexts included concerns about health worker security and moral distress. There are varying levels of institutionalisation and implementation capacity for MPDSR within humanitarian organisations. It is suggested that if poorly implemented, particularly with a punitive or blame approach, MPDSR may be counterproductive. Nevertheless, successes in MPDSR were described whereby the process led to concrete actions to prevent deaths, and where death reviews have led to improved understanding of complex and rectifiable contextual factors leading to deaths in humanitarian settings. Despite the challenges, examples exist where the lessons learnt from MPDSR processes have led to improved access and quality of care in humanitarian contexts, including successful advocacy. An adapted approach is required to ensure feasibility, with varying implementation being possible in different phases of crises. There is a need for guidance on MPDSR in humanitarian contexts, and for greater documentation and learning from experiences. The online version contains supplementary material available at 10.1186/s13031-022-00440-6.
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影响因子：
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作者：
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