Abstract
BackgroundMaternal death reviews is a tool widely recommended to improve the quality of obstetric care and reduce maternal mortality. Our aim was to explore the challenges encountered in the process of facility-based maternal death review in Malawi, and to suggest sustainable and logically sound solutions to these challenges.MethodsSWOT (strengths, weaknesses, opportunities and threats) analysis of the process of maternal death review during a workshop in Malawi.ResultsStrengths: Availability of data from case notes, support from hospital management, and having maternal death review forms. Weaknesses: fear of blame, lack of knowledge and skills to properly conduct death reviews, inadequate resources and missing documentation. Opportunities: technical assistance from expatriates, support from the Ministry of Health, national protocols and high maternal mortality which serves as motivation factor. Threats: Cultural practices, potential lawsuit, demotivation due to the high maternal mortality and poor planning at the district level. Solutions: proper documentation, conducting maternal death review in a blame-free manner, good leadership, motivation of staff, using guidelines, proper stock inventory and community involvement.ConclusionChallenges encountered during facility-based maternal death review are provider-related, administrative, client related and community related. Countries with similar socioeconomic profiles to Malawi will have similar 'pull-and-push' factors on the process of facility-based maternal death reviews, and therefore we will expect these countries to have similar potential solutions.
Highlights
Maternal death reviews is a tool widely recommended to improve the quality of obstetric care and reduce maternal mortality
This study presents the results of SWOT analysis conducted in February 2007 in Malawi (Lilongwe) to identify factors which facilitate or oppose maternal death review process
The participants agreed that having qualified staff to review maternal deaths, case notes to provide information needed for the review and Maternal Death Review Forms to guide the review process have greatly facilitated maternal death review process at facility level
Summary
Maternal death reviews is a tool widely recommended to improve the quality of obstetric care and reduce maternal mortality. More than 99% of these deaths occur in resource-poor countries [2]. Avoiding maternal deaths is possible even in resource-limited countries, but requires the right kind of information on which to base programmes. The term maternal death audit (MDA) is used to describe three approaches used to study the causes and characteristics of maternal deaths [3]. These approaches are confidential enquiry into maternal deaths (CEMD), facilitybased death reviews and community-based death reviews ( called verbal autopsy) [4,5,6,7,8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
