背景:有效使用时,孕产妇和围产期死亡监测和响应(MPDSR)系统可以在与可避免的原因造成的孕产妇和围产期死亡的斗争中取得革命性的胜利。这项研究旨在确定该系统在莫罗戈罗地区的卫生设施中的实施状况。
方法:这项研究是在来自Morogoro地区三个地区的38个医疗机构中进行的,坦桑尼亚,从2020年4月27日至2020年5月29日。定量数据是通过文件审查收集的MPDSR实施状况。通过使用总共30分的独特评分表来确定结果。得分低于11分的设施被认为处于实施前阶段,那些得分11到17的人在实施阶段被考虑,得分18至30分的人被认为处于制度化阶段。
结果:大多数20(53%)的卫生设施处于实施前阶段,只有15家(40%)被评估的卫生设施处于实施阶段,很少有3家(8%)的卫生设施处于制度化阶段。有强有力的证据表明,与农村医疗机构相比,城市的MPDSR实施更为先进(Fisher检验=6.158,p=0.049),与健康中心相比,医院(费希尔检验=14.609,p<0.001),与公共设施相比,私人和基于信仰的组织(费希尔检验,15.897=p=0.002)。
结论:该研究表明,莫罗戈罗地区的医疗机构尚未充分实施MPDSR系统。农村地区和政府拥有的大多数卫生设施显示MPDSR执行情况不佳,因此呼吁立即采取行动纠正这种情况。加强MPDSR实施,应鼓励医疗机构在死亡审查过程中遵守现有的MPDSR指南。还应建立透明的系统,以确保对MPDSR审查产生的建议进行彻底的跟踪和后续行动。卫生设施还应考虑将MPDSR整合到其他质量改进团队中,以最大程度地提高效率。
BACKGROUND: When used effectively, the Maternal and Perinatal Death Surveillance and Response (
MPDSR) system can bring into reality a revolutionary victory in the fight against maternal and perinatal mortality from avoidable causes. This study aimed at determining the status of implementation of the system among health facilities in the Morogoro Region.
METHODS: This study was conducted among 38 health facilities from three districts of the Morogoro region, Tanzania, from April 27, 2020, to May 29, 2020. Quantitative data were collected through document review for
MPDSR implementation status. The outcome was determined by using a unique scoring sheet with a total of 30 points. Facilities that scored less than 11 points were considered to be in the pre-implementation phase, those scored 11 to 17 were considered in the implementation phase, and those scored 18 to 30 were considered to be in the institutionalization phase.
RESULTS: The majority 20(53 %) of health facilities were in the pre-implementation phase, only 15(40 %) of assessed health facilities were in the implementation phase, and few 3(8 %) of health facilities were in institutionalization phase. There was a strong evidence that
MPDSR implementation was more advanced in urban compared to rural health facilities (Fisher\'s test = 6.158, p = 0.049), hospitals compared to health centers (Fisher\'s test =14.609, p <0.001) and private and faith-based organization than public facilities (Fisher\'s test, 15.897 = p = 0.002).
CONCLUSIONS: The study revealed that health facilities in Morogoro Region have not adequately implemented the MPDSR system. The majority of health facilities in rural settings and owned by the government showed poor MPDSR implementation and hence called for immediate action to rectify the situation. Strengthen
MPDSR implementation, health facilities should be encouraged to adhere to the available
MPDSR guidelines in the process of death reviews. Transparent systems should also be established to ensure thorough tracking and follow-up of recommendations evolving from MPDSR reviews. Health facilities should also consider integrating
MPDSR to other quality improvement teams to maximize its efficiency.