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Cited by 234Global Maternal and Child HealthMaternal and Neonatal HealthcareMaternal and fetal healthcare

The DOI matches its Crossref record; 58 of the 58 references it cites were found in a registry or an index.

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

Open access
Kerber, Kate J, Mathai, Matthews, Lewis, Gwyneth, Flenady, Vicki, Erwich, Jan Jaap HM, Segun, Tunde, Aliganyira, Patrick, Abdelmegeid, Ali, Allanson, Emma, Roos, Nathalie, Rhoda, Natasha, Lawn, Joy E, Pattinson, Robert·2015·BMC Pregnancy and Childbirth
DOI 10.1186/1471-2393-15-s2-s9PMC PMC4577789
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Abstract

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.

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Crossref · 10.1186/1471-2393-15-s2-s9

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Figure 1 Perinatal audit parameters by level of care. National level image source: Save the Children. Facility level image source: Ian Hurley/Save the Children. Community level: Save the Children
Figure 1 Perinatal audit parameters by level of care. National level image source: Save the Children. Facility level image source: Ian Hurley/Save the Children. Community level: Save the ChildrenCC BY · PubMed Central
Figure 2 Lessons learned from 60 years of confidential enquiries and maternal death review. FIGO: International Federation of Gynecology and Obstetrics.
Figure 2 Lessons learned from 60 years of confidential enquiries and maternal death review. FIGO: International Federation of Gynecology and Obstetrics.CC BY · PubMed Central
Figure 3 Adoption of maternal and perinatal death notification in Countdown priority countries. Countries with perinatal mortality audit in policy or a national system for facility review of perinatal deaths in 2014: 17 (Angola, Azerbaijan, Bangladesh, Gabon, Gambia, Indonesia, Iraq*, Kenya, Liberia*, Mexico*, South Africa, Rwanda, Tanzania, Uganda, Uzbekistan, Zambia*, Zimbabwe). *refers to stillbirths only or early neonatal only; not both. Sources: [9,13,61,62] See additional file 1 for more details.
Figure 3 Adoption of maternal and perinatal death notification in Countdown priority countries. Countries with perinatal mortality audit in policy or a national system for facility review of perinatal deaths in 2014: 17 (Angola, Azerbaijan, Bangladesh, Gabon, Gambia, Indonesia, Iraq*, Kenya, Liberia*, Mexico*, South Africa, Rwanda, Tanzania, Uganda, Uzbekistan, Zambia*, Zimbabwe). *refers to stillbirths only or early neonatal only; not both. Sources: [9,13,61,62] See additional file 1 for more details.CC BY · PubMed Central
Figure 4 South Africa's experience with perinatal mortality audit. PPIP: Perinatal Problem Identification Programme
Figure 4 South Africa's experience with perinatal mortality audit. PPIP: Perinatal Problem Identification ProgrammeCC BY · PubMed Central
Figure 5 Learning from perinatal mortality or near-miss audit at scale in high income country settings.
Figure 5 Learning from perinatal mortality or near-miss audit at scale in high income country settings.CC BY · PubMed Central
Figure 6 Using mHealth and technology to facilitate mortality audit. PPIP: perinatal problem identification programme. PC: personal computer. DCF: data capture forms. MOH: Ministry of Health.
Figure 6 Using mHealth and technology to facilitate mortality audit. PPIP: perinatal problem identification programme. PC: personal computer. DCF: data capture forms. MOH: Ministry of Health.CC BY · PubMed Central
Figure 7 Key messages and action points.
Figure 7 Key messages and action points.CC BY · PubMed Central

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Citations

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Research works printed but not linked: 7

  1. UNICEF, WHO: Fulfilling the health agenda for women and children: Countdown to 2015 for Maternal, Newborn and Child Survival. 2014, Geneva: WHO
  2. WHO: Everybody's business -- strengthening health systems to improve health outcomes : WHO's framework for action. 2007, Geneva: World Health Organization
  3. Flenady V, King J, Charles A, Gardener G, Ellwood D, Day K, McCowan L, Kent A, Tudehope D, Richardson R, et al: PSANZ Clinical Practice Guideline for Perinatal Mortality. Version 2.2. 2009, Queensland: Perinatal Society of Australia and New Zealand
  4. PMNCH: A Global Review of the Key Interventions Related to Reproductive, Maternal, Newborn and Child Health (RMNCH). 2011, Geneva, Switzerland: The Partnership for Maternal, Newborn & Child Health
  5. Jagau A: ACT for Birth: Improving the Quality of Care in Uganda. 2012
  6. Woods DL: Saving Mothers and Babies: Assessing and reducing mortality rates in your hospital. 2011, Cape Town: Perinatal Education Programme
  7. Commission on Information and Accountability: Keeping promises, measuring results: Commission on Information and Accountability for Women's and Children's Health. 2011, Geneva: World Health Organization

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Metadata

Authors
Kerber, K. J., Mathai, M., Lewis, G., Flenady, V., Erwich, J. J. H., Segun, T., Aliganyira, P., Abdelmegeid, A., Allanson, E., Roos, N., Rhoda, N., Lawn, J. E., & Pattinson, R.
Affiliations
  • Save the Children (US)
  • World Health Organization (CH)
  • University College London (GB)
  • The University of Queensland (AU)
  • University Medical Center Groningen (NL)
  • Jhpiego (US)
  • The University of Western Australia (AU)
  • University of Cape Town (ZA)
  • South African Medical Research Council (ZA)
Corresponding author
Kerber, Kate J
ORCID
Venue
BMC Pregnancy and Childbirth
Publisher
Springer Science and Business Media LLC
Published
2015-09-11
Volume
15
Issue
S2
Pages
S9-S9
ISSN
1471-2393 (ISSN-L)
DOI
10.1186/1471-2393-15-s2-s9
PMC
PMC4577789
OpenAlex
W1924529051
Cited by
231
References
58
Citations by year
2026: 6 · 2025: 11 · 2024: 21 · 2023: 8 · 2022: 16 · 2021: 46 · 2020: 26 · 2019: 33 · 2018: 24 · 2017: 17 · 2016: 15 · 2015: 8
FWCI
3.22
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Pregnancy and Childbirth (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • UWA Profiles and Research Repository (UWA) (submittedVersion, other-oa)
  • Open University of Cape Town (University of Cape Town) (submittedVersion, cc-by)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
Funders
World Health Organization
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
Keywords
stillbirth, neonatal death, Every Newborn Action Plan, cause of death classification, health information systems, health system leadership, avoidable causes of death, quality of care, low- and middle-income countries, health policy implementation
MeSH terms
Africa, Asia, Developing Countries, Female, Health Policy, Humans, Infant, Newborn, Leadership, Medical Audit, Postnatal Care, Pregnancy, Prenatal Care, Practice Guidelines as Topic, Stillbirth, Perinatal Mortality, Quality Improvement, Healthcare Financing, Health Information Systems, Maternal Death, Perinatal Death

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