Experiences with facility-based maternal death reviews in northern Nigeria

The journal article Experiences with facility-based maternal death reviews in northern Nigeria presents the findings of a study evaluating the effectiveness of the use of facility-based MDRs by the Partnership for Reviving Routine Immunization in Northern Nigeria – Maternal Newborn and Child Health (PRRINN-MNCH).

The evaluation uncovers a number of findings, including:

  • Only 93 (12.1%) of the total maternal deaths reported in HMIS for the same facilities had been recorded on the MDR forms and only 52 of these maternal deaths had been reviewed; a mere 6.7%.
  • Despite the minimal number of MDRs taking place in these facilities, the MDRs that were conducted did result in improved quality of care, such as the better management of patients and the mobilisation of resources.
  • The process of using MDRs stopped for some time in the 11 hospitals visited for the study. Reasons included the transfer of key MDR committee members, inadequate supportive supervision and shortage of staff. Most did, however, restart with revitalisation of the MDR process by PRRINN-MNCH staff.
  • Challenges reported included fear of blame felt by health workers, shortage of staff to undertake committee meetings, inadequate supportive supervision and low quality record keeping.

The authors conclude by highlighting successful features of the MDR process, including teamwork, commitment, champions at the health facility level to lead the process, and guidance, coordination and support from the national and state Ministries of Health.

Full reference: Hofman, J.J., & Mohammed, H. (2014). Experiences with facility-based maternal death reviews in northern Nigeria. International Journal of Gynecology and Obstetrics, 126 (2): 111–114.