Evaluation of the maternal deaths surveillance and response system at the health district level in Guinea in 2017 through digital communication tools.


Journal

Reproductive health
ISSN: 1742-4755
Titre abrégé: Reprod Health
Pays: England
ID NLM: 101224380

Informations de publication

Date de publication:
18 Jan 2019
Historique:
received: 16 08 2018
accepted: 09 01 2019
entrez: 20 1 2019
pubmed: 20 1 2019
medline: 12 2 2019
Statut: epublish

Résumé

Reducing maternal mortality still remains a major challenge in low-income countries. This study aims to explore how digital communication tools can be used to evaluate the maternal deaths surveillance and response (MDSR) system at the health district level in Guinea. A descriptive cross-sectional study was conducted, using an innovative digital approach called District.Team, from April to September 2017. This study targeted all 38 district medical officers in Guinea. In addition to district medical officers, the participation of health actors from regional and central levels were also expected in the online discussion forum. Data collected through the questionnaire were mixed and those from the online discussion forum were entirely qualitative. In total, 23 (61%) district medical officers (DMOs) participated in the study. Out of health districts (87%) which had updated guidelines and standards for the MDSR, 4 (20%) did not apply the content. In two health districts (8.7%), not all health facilities had maternal deaths notification forms. Three districts (13%) did not have maternal death review committees. In 2016, only half (50.2%) of reported maternal deaths were reviewed. The main recommendation formulated was related to quality of care. Other needs were also highlighted including continuous training of health care providers on emergency obstetric and neonatal care. Less than half (45%) of the review committee's recommendations were implemented. Six health districts (26.1%) did not have a response plan to reported maternal deaths and no district annual report on the MDSR was published in 2016. The weaknesses identified were, among others, insufficiency of human resources and lack of financial resources. Fifty-eight messages related to MDSR weaknesses and improvement solutions were posted in the online discussion forum by 28 participants (23 DMOs and 5 health actors from regional and central levels). Digital tools can be used to assess the functioning of a system like maternal deaths surveillance and response. Moreover, the findings of the evaluation conducted will help stakeholders (starting from the health districts themselves) to design strategies and interventions for an effective MDSR.

Sections du résumé

BACKGROUND BACKGROUND
Reducing maternal mortality still remains a major challenge in low-income countries. This study aims to explore how digital communication tools can be used to evaluate the maternal deaths surveillance and response (MDSR) system at the health district level in Guinea.
METHODS METHODS
A descriptive cross-sectional study was conducted, using an innovative digital approach called District.Team, from April to September 2017. This study targeted all 38 district medical officers in Guinea. In addition to district medical officers, the participation of health actors from regional and central levels were also expected in the online discussion forum. Data collected through the questionnaire were mixed and those from the online discussion forum were entirely qualitative.
RESULTS RESULTS
In total, 23 (61%) district medical officers (DMOs) participated in the study. Out of health districts (87%) which had updated guidelines and standards for the MDSR, 4 (20%) did not apply the content. In two health districts (8.7%), not all health facilities had maternal deaths notification forms. Three districts (13%) did not have maternal death review committees. In 2016, only half (50.2%) of reported maternal deaths were reviewed. The main recommendation formulated was related to quality of care. Other needs were also highlighted including continuous training of health care providers on emergency obstetric and neonatal care. Less than half (45%) of the review committee's recommendations were implemented. Six health districts (26.1%) did not have a response plan to reported maternal deaths and no district annual report on the MDSR was published in 2016. The weaknesses identified were, among others, insufficiency of human resources and lack of financial resources. Fifty-eight messages related to MDSR weaknesses and improvement solutions were posted in the online discussion forum by 28 participants (23 DMOs and 5 health actors from regional and central levels).
CONCLUSION CONCLUSIONS
Digital tools can be used to assess the functioning of a system like maternal deaths surveillance and response. Moreover, the findings of the evaluation conducted will help stakeholders (starting from the health districts themselves) to design strategies and interventions for an effective MDSR.

Identifiants

pubmed: 30658674
doi: 10.1186/s12978-019-0671-3
pii: 10.1186/s12978-019-0671-3
pmc: PMC6339333
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

5

Références

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pubmed: 25880644
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pubmed: 24559148
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pubmed: 25636651
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pubmed: 28963171
BMJ Open. 2015 Apr 20;5(4):e007753
pubmed: 25897028
Glob Health Sci Pract. 2017 Sep 28;5(3):333-337
pubmed: 28963168
Afr J Reprod Health. 2018 Jun;22(2):17-25
pubmed: 30052330
J Obstet Gynaecol Can. 2015 Oct;37(10):915-21
pubmed: 26606709
BMC Pregnancy Childbirth. 2008 Sep 11;8:42
pubmed: 18786267
Learn Health Syst. 2020 Aug 28;5(4):e10244
pubmed: 34667871
Health Res Policy Syst. 2017 Mar 1;15(1):16
pubmed: 28249608
Womens Health Issues. 2009 Jan-Feb;19(1):14-20
pubmed: 19111783

Auteurs

Tamba Mina Millimouno (TM)

Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea. minamillimouno@gmail.com.
Health Services Delivery Community of Practice, Antwerp, Belgium. minamillimouno@gmail.com.

Sidikiba Sidibé (S)

Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea.
Health Services Delivery Community of Practice, Antwerp, Belgium.

Alexandre Delamou (A)

Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea.
Department of Public Health, Gamal Abdel Nasser University, Conakry, Guinea.

Kéfilath Olatoyossi Akankè Bello (KOA)

Health Services Delivery Community of Practice, Antwerp, Belgium.
Centre de Recherche en Reproduction Humaine et en Démographie, Cotonou, Benin.

Basile Keugoung (B)

Health Services Delivery Community of Practice, Antwerp, Belgium.

Jean Paul Dossou (JP)

Health Services Delivery Community of Practice, Antwerp, Belgium.
Centre de Recherche en Reproduction Humaine et en Démographie, Cotonou, Benin.

Abdoul Habib Beavogui (AH)

Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea.

Bruno Meessen (B)

Health Services Delivery Community of Practice, Antwerp, Belgium.
Institute of Tropical Medicine, Antwerp, Belgium.

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