| dc.description.abstract | Background: An audit by WHO (2010) revealed that there were low levels of maternal deaths reporting, lack of reporting forms, and lack of understanding of classification of various causes of death according to the International Classification of Diseases. An analysis of DHIS2 (2017) data was done and a comparison of the number of deaths reported on the Integrated Disease Surveillance and Response (IDSR) and MoH 711, discovered that IDSR is under-utilized and inaccurate. This data analysis revealed that on average only 39% and 11% of maternal and neonatal deaths respectively, are reported as emergency events in the four counties.
Problem: In the earlier years there has been an underreporting of maternal and neonatal deaths, poor compliance with the MoH MPD notifications circular, and lack of supporting evidence on actions taken after MDR recommendations, reported at the national and facility levels. MPDSR forms were incorporated into the DHIS2 but the system still has gaps and not all maternal deaths are adequately captured on DHIS2. Aim: The aim of the study was to unearth the workflow challenges which hinder the prompt reporting of maternal and neonatal deaths and to understand the surveillance cycle in use then propose a suitable solution. Digitization of the maternity register was explored as a solution.
Methods: A purposive sampling was used to select the research participants and regions to collect the data from. The staff directly involved in the reporting of maternal and new-born deaths were targeted. They included maternity ward-in-charges, surveillance focal persons, health records personnel, and the county health management teams. The awareness of the standard operating procedures and notification policies on zero-reporting was evaluated, as well as the preparedness of reporters, the availability of IDSR reporting tools, and the reporting process.
Results: The pre-study conducted in Kwale, Kisumu, Vihiga and Siaya indicated that the maternity staff were not aware that they were required to send death notifications to the IDSR office within 24 hours after the death occurs, only 3 (8%) respondents had seen a maternal and perinatal death standard operating procedure (SOP), the weekly reporting tool was not readily available in 15 (38%) facilities, only 8 (20%) facilities had a clear reporting cycle. Taking advantage of this potential, we designed and piloted a digitized maternity register for the maternity unit nurses and assessed its impact to improve timeliness in reporting, arithmetic accuracy, and data completeness in St. Marys Langata Hospital, Mbagathi
Hospital, and St Patricks Health Centre. The web based register helped reduce time spent collating the data by 84%, eliminate manual aggregation which was inaccurately done according to the 100% of users in agreement as well as tools unavailability barrier which previously affected submission of the reports. Conclusions: The digitized maternity register was seen to improve the reporting process of the maternal and new-born deaths in Kenya. This research therefore recommends the use of such registers in health facilities to ensure efficient and easy data collection, transmission and analysis systems for quicker response. | en_US |
