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Improving maternal and child health systems in Fiji through a perinatal mortality audit

2015; Elsevier BV; Volume: 129; Issue: 2 Linguagem: Inglês

10.1016/j.ijgo.2014.11.010

1879-3479

Shanti Raman, Alexandra Iljadica, Rajat Gyaneshwar, Rigamoto Taito, James Fong,

Global Health Care Issues

International Journal of Gynecology & ObstetricsVolume 129, Issue 2 p. 165-168 Clinical articles Improving maternal and child health systems in Fiji through a perinatal mortality audit Shanti Raman, Corresponding Author Shanti Raman [email protected] Department of Community Paediatrics, Liverpool Hospital, South Western Sydney Local Health District, Liverpool, NSW, AustraliaCorresponding author at: Department of Community Paediatrics, Liverpool Hospital Campus, Locked Bag 7017, Liverpool BC NSW 1871, Australia. Tel.: + 61 2 8738 4844; fax: + 61 2 8738 4800.Search for more papers by this authorAlexandra Iljadica, Alexandra Iljadica Discipline of International Business, University of Sydney, Camperdown, NSW, AustraliaSearch for more papers by this authorRajat Gyaneshwar, Rajat Gyaneshwar College of Medicine, Nursing and Health Sciences, Lautoka Hospital, Fiji National University, Lautoka, FijiSearch for more papers by this authorRigamoto Taito, Rigamoto Taito College of Medicine, Nursing and Health Sciences, Lautoka Hospital, Fiji National University, Lautoka, FijiSearch for more papers by this authorJames Fong, James Fong Department of Obstetrics and Gynecology, Colonial War Memorial Hospital, Suva, FijiSearch for more papers by this author Shanti Raman, Corresponding Author Shanti Raman [email protected] Department of Community Paediatrics, Liverpool Hospital, South Western Sydney Local Health District, Liverpool, NSW, AustraliaCorresponding author at: Department of Community Paediatrics, Liverpool Hospital Campus, Locked Bag 7017, Liverpool BC NSW 1871, Australia. Tel.: + 61 2 8738 4844; fax: + 61 2 8738 4800.Search for more papers by this authorAlexandra Iljadica, Alexandra Iljadica Discipline of International Business, University of Sydney, Camperdown, NSW, AustraliaSearch for more papers by this authorRajat Gyaneshwar, Rajat Gyaneshwar College of Medicine, Nursing and Health Sciences, Lautoka Hospital, Fiji National University, Lautoka, FijiSearch for more papers by this authorRigamoto Taito, Rigamoto Taito College of Medicine, Nursing and Health Sciences, Lautoka Hospital, Fiji National University, Lautoka, FijiSearch for more papers by this authorJames Fong, James Fong Department of Obstetrics and Gynecology, Colonial War Memorial Hospital, Suva, FijiSearch for more papers by this author First published: 17 January 2015 https://doi.org/10.1016/j.ijgo.2014.11.010Citations: 5Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Abstract Objective To develop a standardized process of perinatal mortality audit (PMA) and improve the capacity of health workers to identify and correct factors underlying preventable deaths in Fiji. Methods In a pilot study, clinicians and healthcare managers in obstetrics and pediatrics were trained to investigate stillbirths and neonatal deaths according to current guidelines. A pre-existing PMA datasheet was refined for use in Fiji and trialed in three divisional hospitals in 2011–12. Key informant interviews identified factors influencing PMA uptake. Results Overall, 141 stillbirths and neonatal deaths were analyzed (57 from hospital A and 84 from hospital B; forms from hospital C excluded because incomplete/illegible). Between-site variations in mortality were recorded on the basis of the level of tertiary care available; 28 (49%) stillbirths were recorded in hospital A compared with 53 (63%) in hospital B. Substantial health system factors contributing to preventable deaths were identified, and included inadequate staffing, problems with medical equipment, and lack of clinical skills. Leadership, teamwork, communication, and having a standardized process were associated with uptake of PMA. Conclusion The use of PMAs by health workers in Fiji and other Pacific island countries could potentially rectify gaps in maternal and neonatal service delivery. Citing Literature Supporting Information Supplementary Material S1 Filename Description mmc1.docxapplication/docx, 497.4 KB The revised and simplified perinatal and neonatal mortality datasheet used. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article. Volume129, Issue2May 2015Pages 165-168 RelatedInformation