Mwaniki Benson K, Edwards Jeffrey K, Kizito Walter
County Government of Kiambu, Department of Health Services.
Médecins Sans Frontières, Luxembourg.
Afr J Reprod Health. 2020 Dec;24(4):122-131. doi: 10.29063/ajrh2020/v24i4.13.
In response to high maternal mortality ratio (MMR) Kenya implemented mandatory maternal death reviews (MDR) in 2004. This retrospective study used MDR data to assess the completeness of MDR process in seven hospitals of Thika sub-county, central Kenya from January 2015 to June 2018. Of all 43 maternal deaths that occurred, 98% were notified while 64% were audited. MDR forms were filled in 55% of the cases of which only 7% had complete documentation. The median age of patients was 30 years majority of whom died within 24 hours of admission. Caesarean sections were associated with 48% of deaths, with haemorrhage accounting for most of the direct causes. Data on hospital-related delays, missed opportunities and action points were most frequently omitted in MDR forms. Capacity building for audit teams is recommended to improve quality of MDR process particularly focusing on identifying causes of preventable maternal deaths.
为应对高孕产妇死亡率，肯尼亚于2004年实施了强制性孕产妇死亡审查（MDR）。这项回顾性研究利用MDR数据评估了2015年1月至2018年6月期间肯尼亚中部锡卡县七家医院MDR流程的完整性。在所有发生的43例孕产妇死亡中，98%得到了通报，64%接受了审核。55%的病例填写了MDR表格，其中只有7%有完整的记录。患者的中位年龄为30岁，大多数患者在入院后24小时内死亡。剖宫产与48%的死亡有关，出血是大多数直接原因。MDR表格中最常遗漏与医院相关的延误、错失机会和行动要点的数据。建议对审核团队进行能力建设，以提高MDR流程的质量，尤其要着重查明可预防孕产妇死亡的原因。
