Mutsigiri-Murewanhema Faith, Mafaune Patron Trish, Juru Tsitsi, Gombe Notion Tafara, Bangure Donewell, Mungati More, Tshimanga Mufuta
Department of Community Medicine, University of Zimbabwe, Zimbabwe.
Ministry of Health and Child Care, Zimbabwe.
Pan Afr Med J. 2017 Jul 18;27:204. doi: 10.11604/pamj.2017.27.204.7210. eCollection 2017.
In Zimbabwe the integrated disease surveillance and response guidelines include maternal mortality as a notifiable event reported through the Maternal Mortality Surveillance System (MMSS). A preliminary review of the MMSS data for Mutare district for the period January to June 2014 revealed that there were some discrepancies in cases notified and those captured on the T5 monthly return form. There were also delays in reporting of some maternal deaths. Poor reporting indicated shortcomings in the MMSS in Mutare district and we therefore sought to assess the performance of the maternal mortality surveillance system in Mutare district.
A descriptive cross sectional study was conducted using Centers for Disease Control and Prevention updated guidelines for evaluating public health surveillance systems. A total of 64 health workers were enrolled into the study from 19 selected health facilities in Mutare district and 32 maternal death notification forms submitted in 2014 to the provincial office were reviewed to assess the quality of information on the forms. Interviewer administered questionnaires were used to collect information from enrolled health workers, the system's attributes namely usefulness, acceptability, simplicity, stability, data quality, timeliness and completeness were assessed and a checklist was used to assess availability of resources for the implementation of the maternal mortality surveillance. We also determined the cost of reporting each maternal death in Mutare district.
Half of the study participants gave the correct definition of a maternal death. All health workers participated and were willing to continue participating in the maternal mortality surveillance. Majority of health workers, 79.7% used data generated from the surveillance system and 59.5% found it easy to implement the system. A total of 32 death notification forms were reviewed and of these, 31 forms were forwarded to the national office and all did not reach the national office on time. Average completeness of notification forms was 76.0% and 53.1% of the forms had all the necessary accompanying documents. Reporting each maternal death was estimated to cost $28.65 in Mutare district.
The strongest components of the maternal mortality surveillance system in Mutare district were usefulness and acceptability. Timeliness and completeness were the weaker components of the system. The system was found to be simple; however, resources were not adequately available in all health facilities.
在津巴布韦，综合疾病监测与应对指南将孕产妇死亡列为需通过孕产妇死亡监测系统（MMSS）报告的应通报事件。对穆塔雷区2014年1月至6月期间MMSS数据的初步审查显示，通报的病例与T5月度申报表记录的病例存在一些差异。部分孕产妇死亡报告也存在延迟。报告不力表明穆塔雷区MMSS存在缺陷，因此我们试图评估穆塔雷区孕产妇死亡监测系统的绩效。
采用美国疾病控制与预防中心更新的公共卫生监测系统评估指南进行描述性横断面研究。从穆塔雷区19家选定的医疗机构中招募了64名卫生工作者参与研究，并对2014年提交给省级办公室的32份孕产妇死亡通报表进行审查，以评估表格上信息的质量。通过访谈者管理的问卷收集参与研究的卫生工作者的信息，评估该系统的属性，即有用性、可接受性、简易性、稳定性、数据质量、及时性和完整性，并使用清单评估实施孕产妇死亡监测的资源可用性。我们还确定了穆塔雷区报告每例孕产妇死亡的成本。
一半的研究参与者给出了孕产妇死亡的正确定义。所有卫生工作者都参与且愿意继续参与孕产妇死亡监测。大多数卫生工作者（79.7%）使用监测系统生成的数据，59.5%的人认为该系统易于实施。共审查了32份死亡通报表，其中31份被转发至国家办公室，但均未按时送达。通报表的平均完整性为76.0%，53.1%的表格附有所有必要的相关文件。据估计，穆塔雷区报告每例孕产妇死亡的成本为28.65美元。
穆塔雷区孕产妇死亡监测系统最强的组成部分是有用性和可接受性。及时性和完整性是该系统较弱的组成部分。该系统被认为是简易的；然而，并非所有医疗机构都有足够的资源。
