Epidemiology, Medical Education and Biostatistics, Department of Community Medicine, Public Health and Family Medicine Faculty of Medicine, Jordan University of Science & Technology, Irbid 22110, Jordan.
Child and Adolescent Health, Allied Medical Sciences Department, Faculty of Applied Medical Sciences, Adjunct Professor at the Faculty of Nursing, Jordan University of Science and Technology, P.O. Box (3030) Irbid, 22110, Jordan.
Biomed Res Int. 2021 Mar 27;2021:8871287. doi: 10.1155/2021/8871287. eCollection 2021.
Facility-based death review committee (DRC) of neonatal deaths and stillbirths can encourage stakeholders to enhance the quality of care during the antenatal period and labour to improve birth outcomes. To understand the benefits and impact of the DRCs, this study was aimed at exploring the DRC members' perception about the role and benefits of the newly developed facility-based DRCs in five pilot hospitals in Jordan, to assess women empowerment, decision-making process, power dynamics, culture and genderism as contributing factors for deaths, and impact of COVID-19 lockdown on births.
A descriptive study of a qualitative design-using focus group discussions-was conducted after one year of establishing DRCs in 5 pilot large hospitals. The number of participants in each focus group ranged from 8 to10, and the total number of participants was 45 HCPs (nurses and doctors). Questions were consecutively asked in each focus group. The moderator asked the main questions from the guide and then used probing as needed. A second researcher observed the conversation and took field notes.
Overall, there was an agreement among the majority of DRC members across all hospitals that the DRC was successful in identifying the exact cause of neonatal deaths and stillbirths as well as associated modifiable factors. There was also a consensus that the DRC contributed to an improvement in health services provided for pregnant women and newborns as well as protecting human rights and enabling women to be more interdependent in taking decisions related to family planning. Moreover, the DRC agreed that a proportion of the neonatal deaths and stillbirths occurring in the hospitals could have been prevented if adequate antenatal care was provided and some traditional harmful practices were avoided.
Facility-based neonatal death review audit is practical and can be used to identify exact causes of maternal and neonatal deaths and is a valuable tool for hospital quality indicators. It can also change the perception and practice of health care providers, which may be reflected in improving the quality of provided healthcare services.
医疗机构内的新生儿死亡和死产评审委员会（DRC）可以鼓励利益相关者提高围产期和分娩期间的护理质量，以改善分娩结局。为了了解 DRC 的益处和影响，本研究旨在探讨新成立的医疗机构内 DRC 成员对 5 家试点医院中 DRC 作用和益处的看法，评估增强妇女权能、决策过程、权力动态、文化和性别主义对死亡的影响因素，以及 COVID-19 封锁对分娩的影响。
在 5 家试点大型医院设立 DRC 一年后，采用描述性定性设计（使用焦点小组讨论）进行了这项研究。每个焦点小组的参与者人数从 8 到 10 人不等，总参与者人数为 45 名医护人员（护士和医生）。在每个焦点小组中都连续提出了问题。主持人根据指南提出主要问题，然后根据需要进行追问。第二名研究人员观察对话并做现场记录。
总体而言，所有医院的大多数 DRC 成员都认为 DRC 成功确定了新生儿死亡和死产的确切原因以及相关可改变的因素。他们还一致认为，DRC 有助于改善为孕妇和新生儿提供的卫生服务，保护人权，使妇女在与计划生育有关的决策中更加相互依存。此外，DRC 一致认为，如果提供足够的产前保健并避免一些传统的有害做法，医院内发生的一部分新生儿死亡和死产是可以预防的。
医疗机构内的新生儿死亡评审审核是切实可行的，可以用来确定孕产妇和新生儿死亡的确切原因，是医院质量指标的宝贵工具。它还可以改变医疗保健提供者的观念和实践，这可能反映在改善提供的医疗保健服务的质量上。
