Quality of stillbirth and neonatal death audit in Malawi: A descriptive observational study

Gondwe, Mtisunge, Desmond, Nicola ORCID: https://orcid.org/0000-0002-2874-8569, Aminu, Mamuda ORCID: https://orcid.org/0000-0002-2335-7147 and Allen, Stephen ORCID: https://orcid.org/0000-0001-6675-249X (2022) 'Quality of stillbirth and neonatal death audit in Malawi: A descriptive observational study'. Journal of Clinical Pediatrics and Neonatology, Vol 2, Issue 1, pp. 13-25.

Preview

Text 27_638023686624189796.pdf - Published Version Available under License Creative Commons Attribution. Download (1MB) | Preview

Abstract

WHO developed a guideline for implementing stillbirth and neonatal death audits at healthcare facilities in 2016. Like many other poor resource countries, stillbirths and neonatal deaths rates remain high in Malawi despite implementation of audit. This paper assesses the quality of facility-based stillbirth and neonatal death audit implementation in Malawian hospitals and provides recommendations for improvement. In accordance with the WHO audit guidelines, we applied mixed methods to determine the quality of audit implementation in seven hospitals in Malawi. We reviewed hospital surveillance data; audit document forms and action plans. We sought staff perceptions and opinions through a questionnaire and interviews and observed audit meetings. Quantitative data was analysed using IBM SPSS 26.0 and presented using frequencies and proportions. Qualitative data were analysed using predefined themes in a survey guide. The frequency of audits and number of stillbirth and neonatal deaths audited varied significantly between hospitals. No hospital had national audit guidelines. Deficiencies included limited information on neonatal death audit data collection and reporting tools, incomplete documentation, lack of senior staff commitment and a blame or shame atmosphere. Audit meetings often did not start with review of ward statistics, previous minutes and follow-up as to whether previous recommendations had been implemented. Challenges in analysing audit information and recommending solutions resulted in lowquality action plans. No objective evidence was found that audit recommendations were implemented. Assessed according to WHO guidelines, audits were of low quality resulting in challenges in identifying and addressing factors contributing to mortality. We recommend regular audit implementation, with completion of audit cycles for audit to contribute to mortality reduction.

Item Type:	Article
Subjects:	WA Public Health > WA 30 Socioeconomic factors in public health (General) WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare WQ Obstetrics > Labor > WQ 330 Complications of labor WS Pediatrics > By Age Groups > WS 420 Newborn infants. Neonatology
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.46439/pediatrics.2.018
Depositing User:	Lynn Roberts-Maloney
Date Deposited:	08 Nov 2022 16:48
Last Modified:	08 Jun 2023 07:33
URI:	https://archive.lstmed.ac.uk/id/eprint/21460

Statistics

View details

Actions (login required)

Edit Item