In Nigeria, the Evidence for Action (E4A)-MamaYe programme has continued to provide extensive support to the implementation of maternal and perinatal death surveillance and response (MPDSR) at sub-national levels from October to December 2016.
The programme assisted the Lagos State MPDSR Committee and the Lagos State Accountability Mechanism for maternal, newborn and child health (LASAM) to develop the State-level Facility MPDSR Scorecard. Data from May to July, 2016 from 17 general hospitals with MNCH services were submitted and presented in the scorecard (see excerpt, below).
A total of 68 maternal deaths occurred over the three months and the highest number of deaths were due to hypertensive disorders of pregnancy accounting for 43% of the maternal deaths (see Chart 1). Other causes included haemorrhage (25%), sepsis (16%), ectopic pregnancy (1%) and other causes – including anaemia, retroviral disease, hypovolemic shock, unknown, acute kidney injury, sudden death, severe respiratory distress and others – (15%).
During the same period, 140 perinatal deaths were recorded (see Chart 2). The leading cause of death was birth asphyxia (39% of all perinatal deaths). Other causes of perinatal death were prematurity (19%), neonatal sepsis (6%), neonatal meningitis (5%), neonatal jaundice (4%), neonatal tetanus (1%) and other causes – including congenital anomalies, respiratory distress syndrome, stillbirth, intrauterine foetal death, sudden infant death syndrome or, hypoglycaemia, and fresh stillbirth and from antepartum haemorrhage – (23%).
The scorecard presents data from each facility on the review of maternal and perinatal deaths, the use of this evidence to inform action plans, the holding of MPDSR meetings, and the process of reporting relevant information from the notification of maternal and perinatal deaths within 24 hours to using MPDSR evidence to improve quality of care.
The State organised a meeting to review the evidence from the MPDSR scorecard. The meeting was chaired by Professor Adetokunbo Fabamwo, Professor of Obstetrics and Gynaecology and Chairman of the State MPDSR Steering Committee. Those who attended the meeting included the Chief Medical Directors of all Lagos State hospitals providing MNCH services, other members of the Facility MPDSR Committees and key senior staff of the State Ministry of Health. Some of the main issues discussed during the meeting were the following :
- Late referrals resulting in late arrivals of obstetric-emergency cases. It was agreed that the State would work with health facilities to strengthen the referral system and increase health education to ensure early presentations at facilities.
- Availability of life-saving medicines and commodities. The Medical Directors must ensure the timely collection of drugs from the Lagos State medical stores and that life-saving drugs are available at their facilities.
- The readiness of referral centres to manage obstetric emergencies. The State MPDSR Committee will recommend that the State Government develops a panel to audit health facilities. This will help identify key areas at the facilities that require improvements in readiness to effectively manage emergencies.
Other State-level updates from E4A-MamaYe Nigeria
Furthermore, in Gombe State, E4A-MamaYe supported the establishment of the State MPDSR Committee, which included training the Committee on the National Guidelines for MPDSR in Nigeria. Training of the Facility MPDSR Committees will take place in the first quarter of 2017.
To view and download the scorecard for free, click here.
To read about state-level updates in MPDSR from northern Nigeria, click here.
To read the Nigeria country update from October 2016, click here.
Acknowledgements: This country update was written by Mr Oko Igado, National Technical Advisor for MamaYe-E4A Nigeria and reviewed by Dr Tunde Segun, Country Director for MamaYe-E4A Nigeria.