Implementation of the Perinatal Death Surveillance and Response guidelines: Lessons from annual health system strengthening interventions in the Rwenzori Sub-Region, Western Uganda.
Enos Mirembe Masereka, Amelia Naturinda, Alex Tumusiime and 1 others
PMID 32802370WHAT IT FOUND
In 20 reviewed facility perinatal deaths in western Uganda, birth asphyxia, malaria in pregnancy and urinary tract infections were common; delays included missed danger signs, long distances, and midwives lacking sign language skills for an aphasic mother.
Key findings
01During the study period, 2,084 deliveries were conducted and 36 perinatal deaths were registered, giving a health facility-based perinatal mortality rate of 17.3 deaths per 1,000 live births.
02Birth asphyxia (eight babies), malaria in pregnancy (four babies) and urinary tract infections (four babies) were the most common probable causes of perinatal deaths.
03Seven mothers delayed to make a decision to seek health care, three mothers delayed reaching the health facility, and ten mothers delayed receiving appropriate interventions at the health facility.
STILL TO COME
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What it does not show
Only 20 of the 36 registered facility perinatal deaths were reviewed; 16 were excluded for inadequate maternal and newborn clinical information. Home perinatal deaths were not included, so the 17.3 deaths per 1,000 live births rate is facility-based and may not represent the community. The study was descriptive and had no comparison group, so it cannot show that Perinatal Death Surveillance and Response implementation or any single support reduced deaths. Causes and avoidable factors were committee judgments from records and questionnaires, not independently measured outcomes. The findings come from one district in western Uganda, so they may not apply to other settings.
Declared interests
The authors declared no competing interests.
The easy way to misread this
Do not conclude that implementing the Perinatal Death Surveillance and Response guidelines reduced perinatal deaths. The study reviewed 20 facility deaths, excluded 16 deaths with poor clinical information and deaths that happened in homes, and had no comparison group or measured change over time.