Implementing Maternal Death Surveillance and Response in Kenya: Incremental Progress and Lessons Learned.

Smith, Helen ORCID: https://orcid.org/0000-0002-6252-3793, Ameh, Charles ORCID: https://orcid.org/0000-0002-2341-7605, Godia, Pamela, Maua, Judith, Bartilol, Kigen, Amoth, Patrick, Mathai, Matthews ORCID: https://orcid.org/0000-0002-7352-9330 and van den Broek, Nynke ORCID: https://orcid.org/0000-0001-8523-2684 (2017) 'Implementing Maternal Death Surveillance and Response in Kenya: Incremental Progress and Lessons Learned.'. Global health, science and practice, Vol 5, Issue 3, pp. 345-354.

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Abstract

Maternal death surveillance and response (MDSR) constitutes a quality improvement approach to identify how many maternal deaths occur, what the underlying causes of death and associated factors are, and how to implement actions to reduce the number of preventable stillbirths and maternal and neonatal deaths. This requires a coordinated approach, ensuring both national- and district-level stakeholders are enabled and supported and can implement MDSR in a "no name, no blame" environment. This field action report from Kenya provides an example of how MDSR can be implemented in a "real-life" setting by summarizing the experiences and challenges faced thus far by maternal death assessors and Ministry of Health representatives in implementing MDSR. Strong national leadership via a coordinating secretariat has worked well in Kenya. However, several challenges were encountered including underreporting of data, difficulties with reviewing the data, and suboptimal aggregation of data on cause of death. To ensure progress toward a full national enquiry of all maternal deaths, we recommend improving the notification of maternal deaths, ensuring regular audits and feedback at referral hospitals lead to continuous quality improvement, and strengthening community linkages with health facilities to expedite maternal death reporting. Ultimately, both a top-down and bottom-up approach is needed to ensure success of an MDSR system. Perinatal death surveillance and response is planned as a next phase of MDSR implementation in Kenya. To ensure the process continues to evolve into a full national enquiry of all maternal deaths, we recommend securing longer-term budget allocation and financial commitment from the ministry, securing a national legal framework for MDSR, and improving processes at the subnational level. [Abstract copyright: © Smith et al.]

Item Type:	Article
Subjects:	WA Public Health > WA 30 Socioeconomic factors in public health (General) WA Public Health > Sanitation. Environmental Control > General Sanitation and Environmental Control > WA 670 General works WA Public Health > Statistics. Surveys > WA 900 Public health statistics WQ Obstetrics > WQ 20 Research (General)
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.9745/GHSP-D-17-00130
SWORD Depositor:	JISC Pubrouter
Depositing User:	Stacy Murtagh
Date Deposited:	23 Oct 2017 15:06
Last Modified:	06 Sep 2019 09:15
URI:	https://archive.lstmed.ac.uk/id/eprint/7684

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