The conduct of maternal and perinatal death reviews in Oyam District, Uganda: a descriptive cross-sectional study. BMC Womens Health 2016 Jul 14;16:38
Date
07/16/2016Pubmed ID
27418127Pubmed Central ID
PMC4944522DOI
10.1186/s12905-016-0315-5Scopus ID
2-s2.0-84978872435 (requires institutional sign-in at Scopus site) 19 CitationsAbstract
BACKGROUND: Uganda like many developing countries still experiences high levels of maternal and perinatal deaths despite a decade of maternal and perinatal death review (MPDR) program. Oyam district has been implementing MPDR since 2008 with varying successes among the health facilities. This paper presents the factors that influence the conduct of maternal and perinatal death reviews in Oyam District, Uganda.
METHODS: This was a cross-sectional study where both qualitative and quantitative data were collected. Semi-structured interviews were administered to 66 health workers and ten key informants (KIs) to assess the factors influencing the conduct of MPDR. Univariate and Bivariate analysis of quantitative data was done using SPSS version 17.0. A Pearson Chi-Square test was done to determine factors associated with conduct of MPDR. Factors with a p-value < 0.05 were considered statistically significant. Qualitative data was analyzed using content analysis.
RESULTS: Only 34.8 % of the health workers had ever participated in MPDR. The factors that influenced conduct of MPDR were existence of MPDR committees (p < 0.001), attendance of review meetings (p < 0.001) and knowledge of objectives of MPDR (p < 0.001), implementation of MPDR recommendations (p < 0.001), observed improvement in maternal and newborn care (p < 0.001) and provision of feedback (p < 0.001). Hindrance to conduct of MPDR was obtained from KIs: the health workers were not made aware of the MPDR process, committee formation and training of MPDR committee members was not effectively done, inadequate support supervision, and lack of financial motivation of MPDR committee members. Challenges to MPDR included: heavy workload to health workers, high number of perinatal deaths, and non-implementation of recommendations.
CONCLUSION: The proportion of maternal and perinatal death reviews conducted in Oyam was low. This was due to poor initiation of the review process and a lack of support supervision. The district and Ministry of Health needs to put more emphasis on monitoring the conduct of maternal and perinatal death reviews by: forming and training MPDR committees and ensuring they are financially supported, providing overall coordination, and ensuring effective support supervision.
Author List
Agaro C, Beyeza-Kashesya J, Waiswa P, Sekandi JN, Tusiime S, Anguzu R, Kiracho EEAuthor
Ronald Anguzu MD, PhD Assistant Professor in the Institute for Health and Equity department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Advisory CommitteesClinical Competence
Cross-Sectional Studies
Female
Forensic Medicine
Health Knowledge, Attitudes, Practice
Health Personnel
Humans
Infant, Newborn
Maternal Death
Perinatal Death
Pregnancy
Qualitative Research
Uganda
