Maternal Death Review
Maternal death audits are an important strategy used to understand the causes of maternal mortality and develop strategies of reducing maternal mortality. Maternal death audits are also considered an important monitoring tool in the Uganda National Roadmap for the accelerated reduction of maternal and newborn mortality in Uganda.
AOGU is participating in a number of activities that would institutionalise maternal death audits in Uganda. This was made possible as part of the AOGU-SOGC Partnership Program. AOGU is a key member of the national committee for Maternal and Perinatal death review and has participated significantly in driving the maternal death review process in this country.
In 2004, a maternal death review pre-conference workshop was convened during tthe AOGU conference hosted by AOGU. At this workshop a rapid assessment of the maternal death review (MDR) process in the region was presented and MDR resolutions for the regions were adopted.
In July 2007, AOGU conducted four one-day workshops for 274 health workers from 11 of the 12 health regions in Uganda. Participants were drawn from health facilities that offered comprehensive emergency obstetric services. The workshops introduced the process of maternal death notification, review and confidential enquiry, hands on experience, and working as teams on the audit process. Participants were introduced to the new maternal death audit form which was being adopted from South Africa. The trainings offered an opportunity for regional obstetricians to meet other Reproductive health workers from lower health units. The trainings showed that it is feasible to get Reproductive health teams working closely at all levels of the health system. At the end of the trainings, maternal audit teams for the various facilities had been constituted.
Under the FIGO Saving Mothers and Newborns Project in Kibaale and Kiboga, part of the on going support supervision in the health facilities, the volunteers were required to initiate and carry out maternal and perinatal death audits in the 6 pilot health facilities. The first teams were tasked with introducing the maternal death notification forms to the health workers in these districts. In Kibaale many of the health workers were seeing them for the first time.
Facilities in Kiboga had previously conducted maternal death reviews with no follow-up actions. Nine of the 18 maternal deaths last year were audited by the volunteers. Poor record keeping was the main reason for lack of auditing.