Background
Globally, there are high rates of death among pregnant women and newborn babies due to poor quality of care. Reviewing deaths of mothers and babies helps health workers, governments and community members identify and solve issues in access and quality of care. This process, known as Maternal and Perinatal Death Surveillance and Response (MPDSR), can reduce deaths by a third.
However, in many countries MPDSR has not had the expected impact due to weak health systems with poor leadership, exclusion of communities from the process, insufficient resources, and lack of training. Fear of blame and punishment discourages people from reporting deaths or providing complete information, so discussions do not address the main issues, and the necessary actions are not taken. Lack of change demotivates health workers and communities. More evidence is needed on how to build a cost-efficient, acceptable MPDSR process, adapted and integrated within local country health systems.
Objectives
The project aims to improve reporting, review and response to deaths of mothers and babies in Ethiopia, Ghana and Uganda, and to evaluate the effect of doing this on death rates of babies.
This four-year project will work with community members and stakeholders in Uganda, Ghana, and Ethiopia to study how deaths of mothers and babies are currently identified, reported and reviewed, and what changes are made in response. This project is led by the University of Southampton in collaboration with the University of Ghana School of Public Health, Haramaya University (Ethiopia), Mbarara University of Science and Technology (Uganda), University of Cape Town (South Africa), the World Health Organisation, Liverpool School of Tropical Medicine, and Leiden University (the Netherlands).
During phase 1 and 2 of the research (2024-2025), we will conduct in-depth research on current MPDSR practices and develop tools to address the main barriers to MPDSR implementation. In phase 3 (2026-2028), each country will introduce an intervention package of the tools developed in phase 2 into 3 districts, starting at different times. We will count deaths of women and babies before and during implementation. We estimate that the number of babies dying can be reduced by 30%. If this approach reduces deaths, and is cost-effective, countries will be supported to scale it up. Our materials will be made available online. This will help to reduce preventable deaths and improve quality of care for women and their babies.
Project lead at LSTM: Dr Abera Kenay Tura
This NIHR research award is funded by the Department of Health and Social Care