Abstract
BackgroundWhen used effectively, the Maternal and Perinatal Death Surveillance and Response (MPDSR) system can bring into reality a revolutionary victory in the fight against maternal and perinatal mortality from avoidable causes. This study aimed at determining the status of implementation of the system among health facilities in the Morogoro Region.MethodThis study was conducted among 38 health facilities from three districts of the Morogoro region, Tanzania, from April 27, 2020, to May 29, 2020. Quantitative data were collected through document review for MPDSR implementation status. The outcome was determined by using a unique scoring sheet with a total of 30 points. Facilities that scored less than 11 points were considered to be in the pre-implementation phase, those scored 11 to 17 were considered in the implementation phase, and those scored 18 to 30 were considered to be in the institutionalization phase.ResultsThe majority 20(53 %) of health facilities were in the pre-implementation phase, only 15(40 %) of assessed health facilities were in the implementation phase, and few 3(8 %) of health facilities were in institutionalization phase. There was a strong evidence that MPDSR implementation was more advanced in urban compared to rural health facilities (Fisher’s test = 6.158, p = 0.049), hospitals compared to health centers (Fisher’s test =14.609, p <0.001) and private and faith-based organization than public facilities (Fisher’s test, 15.897 = p = 0.002).ConclusionsThe study revealed that health facilities in Morogoro Region have not adequately implemented the MPDSR system. The majority of health facilities in rural settings and owned by the government showed poor MPDSR implementation and hence called for immediate action to rectify the situation. Strengthen MPDSR implementation, health facilities should be encouraged to adhere to the available MPDSR guidelines in the process of death reviews. Transparent systems should also be established to ensure thorough tracking and follow-up of recommendations evolving from MPDSR reviews. Health facilities should also consider integrating MPDSR to other quality improvement teams to maximize its efficiency.
Highlights
When used effectively, the Maternal and Perinatal Death Surveillance and Response (MPDSR) system can bring into reality a revolutionary victory in the fight against maternal and perinatal mortality from avoidable causes
The study revealed that health facilities in Morogoro Region have not adequately implemented the MPDSR system
Strengthen MPDSR implementation, health facilities should be encouraged to adhere to the available MPDSR guidelines in the process of death reviews
Summary
The Maternal and Perinatal Death Surveillance and Response (MPDSR) system can bring into reality a revolutionary victory in the fight against maternal and perinatal mortality from avoidable causes. Tanzania is among the sub-Saharan countries with the highest maternal mortality. It has been reported that the most leading causes of maternal deaths are haemorrhage (severe bleeding mainly after childbirth), infections (usually after childbirth), high blood pressure during pregnancy (preeclampsia and eclampsia), and unsafe abortion [3]. These five causes alone contributed to up to 80 % of maternal deaths in 2017 globally [3]. The remaining 20 % were caused by other causes such as when pregnancy was aggravated by other diseases like malaria, HIV, and the like [3]. These causes are preventable if skilled attendants attend pregnant women during pregnancy, childbirth, and the postnatal period
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