What do we know about maternal and perinatal mortality and morbidity audits in sub-Saharan Africa? A scoping literature review

Adelaide Lusambili,Jacinta Nzinga,Mike English,Joyline Jepkosgei

doi:10.1108/ijhrh-07-2018-0052

Adelaide Lusambili, Jacinta Nzinga + Show 2 more

Open Access

https://doi.org/10.1108/ijhrh-07-2018-0052

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Abstract

PurposeThe purpose of this paper is to provide a situational overview of the facility-based maternal and perinatal morbidity and mortality audits (MPMMAs) in SSA, their current efficacy at reducing mortality and morbidity rates related to childbirth.Design/methodology/approachThis is a scoping literature review based on the synthesis of secondary literature.FindingsNot all countries in SSA conduct MPMMAs. Countries where MPMMAs are conducted have not instituted standard practice, MPMMAs are not done on a national scale, and there is no clear best practice for MPMMAs. In addition, auditing process of pediatrics and maternal deaths is flawed by human and organizational barriers. Thus, the aggregated data collected from MPMMAs are not adequate enough to identify and correct systemic flaws in SSA childbirth-related health care.Research limitations/implicationsThere are a few published literature on the topic in sub-Saharan Africa.Practical implicationsThis review exposes serious gaps in literature and practice. It provides a platform upon which practitioners and policy makers must begin to discuss ways of embedding mortality audits in SSA in their health systems as well as health strategies.Social implicationsThe findings of this paper can inform policy in sub-Saharan Africa that could lead toward better outcomes in health and well-being.Originality/valueThe paper is original.

Highlights

A maternal mortality audit is a process that looks at the number and causes of deaths among women who die between conception and six weeks after delivery, while perinatal mortality audit looks at the stillbirths and early neonatal deaths (WHO, 2015, 2016; WB, 2011)
The aim of this review is to improve our understanding on this topic by providing a situational overview of the facility-based maternal and perinatal morbidity and mortality audits (MPMMAs) in SSA, their current efficacy at reducing mortality and morbidity rates related to childbirth
The varied approaches that SSA countries have used over time in collecting MPMMA data make it difficult to evaluate the data collected; and systematic and human factors undermine the effectiveness of MPMMAs

Summary

Introduction

A maternal mortality audit is a process that looks at the number and causes of deaths among women who die between conception and six weeks after delivery, while perinatal mortality audit looks at the stillbirths and early neonatal deaths (WHO, 2015, 2016; WB, 2011). The overall aim is to identify correctible deficiencies (such as omission in care, delayed or missed diagnosis, inappropriate missed drug administration and miscommunication) in order to improve the quality of safe motherhood, as well as to prevent future occurrences (WB, 2011; WHO, 2016; Owolabi et al, 2014). Morbidity audits look at the illness and problems which are not severe enough to cause death (Higginson et al, 2011; WHO, 2016). In HICs, hospitals and other health care facilities have long conducted morbidity and mortality audits to identify deficiencies in health care provision and ways to improve patient outcomes (Kurinczuk et al, 2014; Luz et al, 2014). Routine facility morbidity and mortality audits have been linked to improved quality of care and better health outcomes (WHO, 2004, 2016). Reviews of maternity-related deaths, which began in the 1950s (Short, 1961), have proved especially j j PAGE 192 INTERNATIONAL JOURNAL OF HUMAN RIGHTS IN HEALTHCARE VOL. 12 NO. 3 2019, pp. 192-207, Emerald Publishing Limited, ISSN 2056-4902

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