Assessing Implementation of Maternal and Perinatal Death Surveillance and Response in Rwanda

Edwin Tayebwa, Felix Sayinzoga, Jacqueline Umunyana, Kusum Thapa, Efugbaike Ajayi, Young-Mi Kim, Jeroen van Dillen and Jelle Stekelenburg
Additional contact information
Edwin Tayebwa: IntraHealth International, P.O. Box 6639 Kigali, Rwanda
Felix Sayinzoga: Rwanda Biomedical Center, KG 203 St, Kigali, Rwanda
Jacqueline Umunyana: IntraHealth International, P.O. Box 6639 Kigali, Rwanda
Kusum Thapa: Jhpiego, An Affiliate of Johns Hopkins University, Baltimore, MD 21231, USA
Efugbaike Ajayi: Jhpiego, An Affiliate of Johns Hopkins University, Baltimore, MD 21231, USA
Young-Mi Kim: Jhpiego, An Affiliate of Johns Hopkins University, Baltimore, MD 21231, USA
Jeroen van Dillen: Amalia Children’s Hospital, Radboudumc Nijmegen, 6500 HB Nijmegen, The Netherlands
Jelle Stekelenburg: University Medical Centre Groningen, Department of Health Sciences, Global Health, University of Groningen, 9700 RB Groningen, The Netherlands

IJERPH, 2020, vol. 17, issue 12, 1-11

Abstract: Maternal deaths remain a major public health concern in low- and middle-income countries. Implementation of maternal and perinatal deaths surveillance and response (MPDSR) is vital to reduce preventable deaths. The study aimed to assess implementation of MPDSR in Rwanda. We applied mixed methods following the six-step audit cycle for MPDSR to determine the level of implementation at 10 hospitals and three health centers. Results showed various stages of implementation of MPDSR across facilities. Maternal death audits were conducted regularly, and facilities had action plans to address modifiable factors. However, perinatal death audits were not formally done. Implementation was challenged by lack of enough motivated staff, heavy workload, lack of community engagement, no linkages with existing quality improvement efforts, no guidelines for review of stillbirths, incomplete medical records, poor classification of cause of death, and no sharing of feedback among others. Implementation of MPDSR varied from facility to facility indicating varying capacity gaps. There is need to integrate perinatal death audits with maternal death audits and ensure the process is part of other quality improvement initiatives at the facility level. More efforts are needed to support health facilities to improve implementation of MPDSR and contribute to achieving sustainable development goal (SDG) 3.

Keywords: Audit; maternal; perinatal; death; surveillance; response; implementation; Rwanda (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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