Abstract
BackgroundMaternal Death Surveillance and Response (MDSR) system was established to provide information that effectively guides actions to eliminate preventable maternal mortality. In 2016, Hwange district sent six maternal death notification forms (MDNF) to the province without maternal death audit reports. Timeliness of MDNF reaching the province is a challenge. Two MDNF for deaths that occurred in February and May 2016 only reached the provincial office in September 2016 meaning the MDNF were seven and four months late respectively. We evaluated the MDSR system in Hwange district.MethodsA descriptive cross-sectional study was conducted. Health workers in the sampled facilities were interviewed using questionnaires. Resource availability was assessed through checklists. Epi Info 7 was used to calculate frequencies, means and proportions.ResultsWe recruited 36 respondents from 11 facilities, 72.2% were females. Inadequate health worker knowledge, lack of induction on MDSR, unavailability of guidelines and notification forms and lack of knowledge on the flow of information in the system were reasons for late notification of maternal deaths. Workers trained in MDSR were 83.8%. Only 36.1% of respondents had completed an MDNF before. Respondents who used MDSR data at their level were 91.7%, and they reported that MDSR system was useful. Responsibility to complete the MDNF was placed on health workers. Maternal death case definitions were available in 2/11 facilities, 4/11 facilities had guidelines for maternal death audits. It costs $60.78 to notify a maternal death.ConclusionReasons for late notification of maternal deaths were inadequate knowledge, lack of induction, unavailability of guidelines and notification forms at facilities. The MDSR system is useful, acceptable, flexible, unstable, reliable but not simple. Maternal case definitions and maternal death audit guidelines should be distributed to all facilities. Training of all health workers involved in MDSR is recommended.
Highlights
Maternal Death Surveillance and Response (MDSR) system was established to provide information that effectively guides actions to eliminate preventable maternal mortality
Our study found some inconsistencies from health workers with regards to the number of maternal death notification forms that are completed when notifying a maternal death, half of the health workers correctly mentioned three forms, and the other reported that four maternal death notification forms are completed
Our study revealed that there was a need for training of healthcare workers in the completion of the maternal death notification forms (MDNF), the majority of the health workers had never completed an MDNF before respondents felt that they were inadequately prepared in the event a maternal death occurs at their facility
Summary
Maternal Death Surveillance and Response (MDSR) system was established to provide information that effectively guides actions to eliminate preventable maternal mortality. Maternal Death Surveillance and Response (MDSR) refers to continuous, systematic collection, analysis, interpretation and dissemination of data regarding maternal deaths. It links the health information system and quality improvement processes from local to national levels [1]. This maternal mortality ratio translates to approximately 830 women dying every single day due to the complications of pregnancy and childbirth Almost all these deaths occurred in low Maphosa et al BMC Pregnancy and Childbirth (2019) 19:103 resource settings, and most could have been prevented [6, 7]. Like many other developing nations, Zimbabwe failed to achieve the target for MDG 5 by 2015
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