Experiences with facility-based maternal death reviews in northern Nigeria
Experiences with facility-based maternal death reviews in northern Nigeria
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DOI：
10.1016/j.ijgo.2014.02.014
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发表时间：
2014-08-01
影响因子：
3.8
通讯作者：
Mohammed, Hauwa
中科院分区：
文献类型：
--
作者：
Hofman, Jan J.;Mohammed, Hauwa
目的：评价孕产妇死亡审查（MDR）系统和流程在提高北方尼日利亚孕产妇和新生儿保健质量方面的有效性。研究方法：定量和定性相结合的方法，包括审查MDR的形式和卫生管理信息系统的孕产妇死亡（MD）的数据，以及半结构化的采访11 MDR委员会的成员。结果如下：在北方尼日利亚的75个产科和新生儿急诊护理设施启动了基于设施的医疗器械评估，最初在33家医院进行;然而，这一进程在一段时间后停止，不得不重新启动。主要原因是MDR委员会主要成员的调动;缺乏支持性监督，以及工作人员短缺。768例识别出的MD中，93例（12.1%）记录在MDR表中，52例（6.7%）已接受审查。多边审查提高了护理质量，包括调动了额外资源。面临的挑战是害怕受到指责、工作人员短缺、MDR团队成员的调动、支持性监督不足以及记录保存不良。结论：MDR需要团队合作，承诺，并在卫生设施层面的冠军，以带头的过程。MDR需要在卫生部制度化，卫生部提供监督政策指导和支持，包括支持性监督。(C)2014年国际妇产科联合会。由Elsevier爱尔兰有限公司出版。保留所有权利。
Objective: To evaluate the effectiveness of the maternal death review (MDR) system and process in improving quality of maternal and newborn health care in northern Nigeria. Methods: A combination of quantitative and qualitative methods was used, including review of MDR forms and of health management information system data on maternal deaths (MDs), as well as semi-structured interviews with members of 11 MDR committees. Results: Facility-based MDRs were initiated in 75 emergency obstetric and newborn care facilities in northern Nigeria and were initially conducted in the 33 hospitals; however, the process stopped after some time and had to be revitalized. Main reasons were transfer of key members of MDR committees; lack of supportive supervision, and shortage of staff. Ninety-three (12.1%) of 768 identified MDs were recorded on MDR forms and 52 (6.7%) had been reviewed. MDRs resulted in improved quality of care, including mobilization of additional resources. Challenges were fear of blame, shortage of staff, transfer of MDR team members, inadequate supportive supervision, and poor record keeping. Conclusion: MDR requires teamwork, commitment, and champions at health facility level to spearhead the process. MDR needs to be institutionalized in the Ministry of Health, which provides oversight policy guidance, and support, including supportive supervision. (C) 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.