Professor Affette McCaw-Binns, a Reproductive Health Epidemiologist at the University of the West Indies (Mona) and Dr Simone Spence, Director of Family Health Services at the Ministry of Health in Jamaica explain how legislation and policy strengthened the reporting of maternal deaths in Jamaica. This case study describes how the policy framework was amended to improve the reporting of maternal deaths and how other interventions implemented simultaneously together strengthen the maternal death surveillance and response (MDSR) system.
In the early 1980s1,2, maternal deaths in Jamaica were significantly under-reported in vital registration records by as much as 75%. With over 80% of all live births occurring in public hospitals2 it was suggested that establishing a surveillance system at public hospitals could capture needed information about the number of maternal deaths in the country. Given the findings3, the government agreed to implement an active (as opposed to the pre-existing passive) surveillance system to monitor maternal deaths.
This case study will describe the approaches that the government adopted, including how the legal framework was used in support of strengthening the MDSR system and reversing under-reporting. Continue reading
On 16 August, 2016 the World Health Organization (WHO) launched three new tools to count and review stillbirths, and maternal and neonatal deaths!
Browse the standardised system to capture and classify stillbirths and neonatal deaths in the WHO Application of the International Classification of Disease-10 to deaths during the perinatal period (ICD-PM).
Read the guide and toolkit, Making every baby count: audit and review of stillbirths and neonatal deaths. This publication assists countries to conduct audits and reviews to recommend and put into action solutions to prevent future stillbirths and neonatal deaths.
Explore Time to respond: a report on the global implementation of maternal death surveillance and response to review the findings of the WHO & UNFPA global survey of national MDSR systems in 2015.
Browse the press release and WHO website to learn more about these three tools, including related papers by the BJOG.
Read this Lancet commentary about all three publications.
Explore this photo story to learn more about MDSR implementation in ten countries around the world.
View this infographic about improving data to learn about what the WHO is doing to help countries save mothers’ and babies’ lives.
Do you know how many women each day experience a stillbirth worldwide? Browse this infographic on the tragedy of stillbirths to find out how many, and more!
This report was published in May 2016 and is based on information collected of perinatal deaths in the UK for births from January to December 2014. The document focuses on deaths reported through the secure online reporting system, which include all late foetal losses (22nd to 23rd weeks of gestational age), stillbirths (a baby delivered at or after 24 weeks of gestational age with no signs of life) and neonatal deaths (a liveborn baby delivered at 20 weeks of gestational age or later, or weighing 400g or more when gestation is unavailable) who died within 28 days of being born. The findings are displayed in mortality rates for stillbirths, neonatal deaths and extended perinatal deaths (both stillbirths and neonatal deaths). The report offers key findings and recommendations, as well as describing causes of death and factors that influence rates of perinatal death.
Pattinson et al (2009), published by the International Journal of Gynaecology and Obstetrics, conducted a systematic review and meta-analysis of perinatal mortality audit at the facility level in low- and middle-income countries. The results showed a reduction in perinatal mortality by 30% with the establishment of a perinatal audit system.
The findings suggest that an audit system may be helpful in reducing perinatal deaths in facilities and improving the quality of care. Pattinson and colleagues also reviewed information about community audits and verbal/social autopsy drawing on examples from Africa (Guinea and Uganda) and Asia (Uttar Pradesh, India). Furthermore, two country case studies were presented on scaling up perinatal audit in South Africa and Bangladesh.
The authors identify areas that merit further research and conclude that successful implementation of perinatal audit to improve the quality of care relies on closing the audit cycle.