Basera Tariro J, Schmitz Kathrin, Price Jessica, Willcox Merlin, Bosire Edna N, Ajuwon Ademola, Mbule Marjorie, Ronan Agnes, Burtt Fiona, Scheepers Esca, Igumbor Jude
School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
mothers2mothers, Cape Town, South Africa.
PLoS One. 2021 Mar 16;16(3):e0248143. doi: 10.1371/journal.pone.0248143. eCollection 2021.
Civil registration and vital statistics (CRVS) systems do not produce comprehensive data on maternal and child deaths in most low- and middle-income countries (LMICs), with most births and deaths which occur outside the formal health system going unreported. Community-based death reporting, investigation and review processes are being used in these settings to augment official registration of maternal and child deaths and to identify death-specific factors and associated barriers to maternal and childcare. This study aims to review how community-based maternal and child death reporting, investigation and review processes are carried out in LMICs.
We conducted a scoping review of the literature published in English from January 2013 to November 2020, searching PubMed, EMBASE, PsycINFO, Joanna Briggs, The Cochrane Library, EBM reviews, Scopus, and Web of Science databases. We used descriptive analysis to outline the scope, design, and distribution of literature included in the study and to present the content extracted from each article. The scoping review is reported following the PRISMA reporting guideline for systematic reviews.
Of 3162 screened articles, 43 articles that described community-based maternal and child death review processes across ten countries in Africa and Asia were included. A variety of approaches were used to report and investigate deaths in the community, including identification of deaths by community health workers (CHWs) and other community informants, reproductive age mortality surveys, verbal autopsy, and social autopsy. Community notification of deaths by CHWs complements registration of maternal and child deaths missed by routinely collected sources of information, including the CRVS systems which mostly capture deaths occurring in health facilities. However, the accuracy and completeness of data reported by CHWs are sub-optimal.
Community-based death reporting complements formal registration of maternal and child deaths in LMICs. While research shows that community-based maternal and child death reporting was feasible, the accuracy and completeness of data reported by CHWs are sub-optimal but amenable to targeted support and supervision. Studies to further improve the process of engaging communities in the review, as well as collection and investigation of deaths in LMICs, could empower communities to respond more effectively and have a greater impact on reducing maternal and child mortality.
在大多数低收入和中等收入国家（LMICs），民事登记和人口动态统计（CRVS）系统无法提供关于孕产妇和儿童死亡的全面数据，大多数在正规卫生系统之外发生的出生和死亡未被报告。在这些地区，基于社区的死亡报告、调查和审查流程正在被用于补充孕产妇和儿童死亡的官方登记，并识别特定死亡因素以及孕产妇和儿童护理方面的相关障碍。本研究旨在回顾在低收入和中等收入国家中基于社区的孕产妇和儿童死亡报告、调查和审查流程是如何开展的。
我们对2013年1月至2020年11月以英文发表的文献进行了范围综述，检索了PubMed、EMBASE、PsycINFO、Joanna Briggs、Cochrane图书馆、循证医学综述、Scopus和科学引文索引数据库。我们使用描述性分析来概述纳入研究的文献的范围、设计和分布，并呈现从每篇文章中提取的内容。本范围综述按照系统评价的PRISMA报告指南进行报告。
在3162篇筛选的文章中，纳入了43篇描述非洲和亚洲十个国家基于社区的孕产妇和儿童死亡审查流程的文章。在社区中报告和调查死亡采用了多种方法，包括由社区卫生工作者（CHWs）和其他社区信息提供者识别死亡、育龄期死亡率调查、口头尸检和社会尸检。社区卫生工作者对死亡的社区通报补充了常规收集的信息来源（包括主要记录在卫生设施中发生的死亡的CRVS系统）遗漏的孕产妇和儿童死亡登记。然而，社区卫生工作者报告的数据的准确性和完整性并不理想。
基于社区 的死亡报告补充了低收入和中等收入国家孕产妇和儿童死亡的正式登记。虽然研究表明基于社区的孕产妇和儿童死亡报告是可行的，但社区卫生工作者报告的数据的准确性和完整性并不理想，但可通过有针对性的支持和监督加以改善。进一步改进低收入和中等收入国家让社区参与审查以及死亡收集和调查过程的研究，可以使社区更有效地做出反应，并对降低孕产妇和儿童死亡率产生更大影响。
