Utility of Expert Panel to Identify Preventable Perinatal Deaths: Results from Audit Based Interventional Study in Two Districts of Karnataka State, India

Authors

  • Harsha Kumar H N Subbaiah Institute of Medical Sciences, Shimoga, India
  • Shantaram B Baliga Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
  • Pralhad Kushtagi Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
  • Nutan Kamath Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India
  • Sucheta S Rao Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, India

DOI:

https://doi.org/10.55489/njcm.140820233157

Keywords:

Expert Panel, Perinatal Death Auditing, Preventable Perinatal Deaths, Risk Identification

Abstract

Background: India has child death review which misses the information from private hospitals and community. Community based perinatal death auditing is required to identify preventable perinatal deaths. The objectives are to know utility of expert panel in an audit-based approach to identify 1). preventable perinatal deaths, 2) Risk factors in cases of perinatal deaths

Methodology: Perinatal death auditing was conducted in two districts of Karnataka state. As a part of audit system, an expert panel consisting of paediatricians and obstetricians was formed for each district. The panel met every month and received information about perinatal deaths occurring in the hospitals (government and private) apart from the community in these districts. The panel considered available information about survival chances and care provided to decide if a perinatal death was preventable, possibly preventable or not preventable.

Results: Proportion Of identified preventable and possibly preventable perinatal deaths in Koppal District (60%, 20%) was higher than Dakshina Kannada district (34.4%, 30.2%). The proportion preventable intranatal and neonatal risks in Koppal District (79%, 66%) was higher than Dakshina Kannada District (47%, 19%).

Conclusion: Expert panel is useful to identify preventable perinatal deaths. The pattern of risk identified has implications for improvements in quality of care provided to high-risk cases.

References

Blencowe H, Cousens S, Bianchi Jassir F, Say L, Chou D, Mathers C et al. Stillbirth Epidemiology Investigator Group. National, region-al, and worldwide estimates of stillbirth rates in 2015 with trends from 2000: a systematic analysis. Lancet. 2016;4:e98-e108. Doi: https://doi.org/10.1016/S2214-109X(15)00275-2 PMid:26795602

Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE et al. Global, regional, and national causes of child mortality in 2000-13, with projec-tions to inform post-2015 priorities: an updated systematic analysis. Lancet.2015;385(9966):430-440. Doi: https://doi.org/10.1016/S0140-6736(14)61698-6 PMid:25280870

Rajaratnam JK, Marcus JR, Flaxman AD, Wang H, Levin-Rector A, Dwyer L et al. Neonatal, postneonatal, childhood, and under-5 mor-tality for 187 countries, 1970-2010: a systematic analysis of progress towards millennium development goal 4. Lan-cet.2010;375(9730):1988-2008. Doi: https://doi.org/10.1016/S0140-6736(10)60703-9 PMid:20546887

Lawn JE, Blencowe H, Pattinson R, Cousens S, Kumar R, Ibiebele I et al. Stillbirths: where? when? why? how to make the data count?.Lancet.2011;377(9775):1448-1463. Doi: https://doi.org/10.1016/S0140-6736(10)62187-3 PMid:21496911

Registrar General of India. Sample registration system (SRS) statistical report 2013, New Delhi.Available from the URL [Accessed on 2 August 2018]: http://www.censusindia.gov.in/vital_statistics/Compendium/Srs_data.html

Kumar H N H, Balig BS, Kushtagi P, Kamath N, Rao S. Exploratory study on maternal and child health care facilities in two districts of karnataka state A health systems research. Int J Med Public Heal [Internet]. 2018;8(4):152-7. Doi: https://doi.org/10.5530/ijmedph.2018.4.31

Sankar MJ, Neogi SB, Sharma J, Chauhan M, Srivastava R, Prabhakar PK, et al. State of newborn health in India. J Perinatol. 2016;36(S3):S3-8. Doi: https://doi.org/10.1038/jp.2016.183 PMid:27924104 PMCid:PMC5144119

Bhatt RV. Professional responsibility in maternity care: role of medical audit. Int J Gynaecol Obstet.1989;30(1):47-50. Doi: https://doi.org/10.1016/0020-7292(89)90214-2 PMid:2572472

Upadhyay RP, Chinnakali P, Odukoya O, Yadav K, Sinha S, Rizwan SA, et al. High neonatalmortality rates in rural India: what options to explore?.ISRN Pediatr.2012;968921. Doi: https://doi.org/10.5402/2012/968921 PMid:23213561 PMCid:PMC3506889

Pattinson R, Kerber K, Waiswa P, Day LT, Mussell F, Asiruddin SK et al. Perinatal mortality audit: counting, accountability, and over-coming challenges in scaling up in low- and middle-income countries. Int J Gynaecol Obstet. 2009;107 (Suppl 1):S113-S121. S121-112. Doi: https://doi.org/10.1016/j.ijgo.2009.07.011 PMid:19815206

Kate J Kerber, Matthews Mathai, Gwyneth Lewis, Vicki Flenady, Jan Jaap HM Erwich, Tunde Segun et al. Counting every stillbirth and neonatal death through mortality audit to improve quality of care for every pregnant woman and her baby. BMC Pregnancy and Childbirth.2015;15(Suppl 2):S9 Doi: https://doi.org/10.1186/1471-2393-15-S2-S9 PMid:26391558 PMCid:PMC4577789

World Healh Organization [www.who.int/]. Sustainable development goals. Available from URL [Accessed on 8 January 2021]: https://www.who.int/health-topics/sustainable-development-goals#tab=tab_2

National Health Mission [www.nhm.gov.in]. Child Death Review : Operational guidelines August 2014. Available from URL [Ac-cessed on 8 January 2021]: https://nhm.gov.in/images/pdf/programmes/child-health/guidelines/Operational_Guidelines_Child_Death_Review.pdf

National Health Mission [www.nhm.gov.in]. Maternal Death Review Guidebook. Available from URL [Accessed on 8 January 2021]: https://nhm.gov.in/images/pdf/programmes/maternal-health/guidelines/maternal_death_review_guidebook.pdf

Harsha Kumar H N,, Balig BS, Kushtagi P, Kamath N, Rao S. Documentation and Reporting of Perinatal deaths in Two Districts of Karnataka Stat India: A Situational Analysis. Indian Pediatrics. 2020; 57: 1006-1009. Doi: https://doi.org/10.1007/s13312-020-2024-2

Registrar General of India. Census of India 2011: District Census Handbook Dakshina Kannada. Directorate of Census Operations, Karnataka. Available from the URL [Accessed on 2 August 2018]: http://www.censusindia.gov.in/2011census/dchb/2921_PART_A_DCHB_DAKSHINA%20KANNADA.pdf

Registrar General of India. Census of India 2011: District Census Handbook Koppal. Directorate of Census Operations, Karnataka. Available from the URL [Accessed on 2 August 2018]: http://www.censusindia.gov.in/2011census/dchb/2906_PART_A_DCHB_KOPPAL.pdf

Kumar HN, Baliga SB, Kushtagi P, Kamath N, Rao SS. Development and utility of tools to identify preventable perinatal deaths: results from a community-based interventional study in two districts of Karnataka State, India. Indian J Community Med 2021;46:631-6. Doi: https://doi.org/10.4103/ijcm.IJCM_1004_20 PMid:35068724 PMCid:PMC8729305

Mancey-Jones M, Brugha RF. Using perinatal audit to promote change: a review. Health Policy Plan.1997;12(3):183-192. Doi: https://doi.org/10.1093/heapol/12.3.183 PMid:10173399

El Amin S, Langhoff-Roos J, Bødker B, Bakr AA, Ashmeig AL, Ibrahim SA et al. Introducing qualitative perinatal audit in a tertiary hospital in Sudan. Health Policy Plan. 2002;17:296-303. Doi: https://doi.org/10.1093/heapol/17.3.296 PMid:12135996

Mbaruku G, van Roosmalen J, Kimondo I, Bilango F, Bergström S. Perinatal audit using the 3-delays model in western Tanzania. Int J Gynaecol Obstet. 2009;106:85-88. Doi: https://doi.org/10.1016/j.ijgo.2009.04.008 PMid:19439297

Chigbu CO, Okezie OA, OduguBU.Intrapartum stillbirth in a Nigerian tertiary hospital setting. Int J Gynaecol Obstet. 2009;104:18-21. Doi: https://doi.org/10.1016/j.ijgo.2008.08.011 PMid:18922521

Van Roosmalen J. Perinatal mortality in rural Tanzania.Br J ObsteGynaecol.1989; 96:827-834. Doi: https://doi.org/10.1111/j.1471-0528.1989.tb03323.x PMid:2765428

De Muylder X. Perinatal mortality audit in a Zimbabwean district.Paediatr Perinat Epidemiol.1989;3:284-293. Doi: https://doi.org/10.1111/j.1365-3016.1989.tb00380.x PMid:2788880

Frost O. Maternal and perinatal deaths in an Addis Ababa Hospital, 1980. Ethiop Med J. 1984;22(3):143-146.

Johnstone FD, Ochiel SO.Perinatal mortality at Kenyatta National Hospital Nairobi. EastAfr Med J. 1980;57:119-123.

Hinderaker SG, Olsen BE, Bergsjo PB, Gasheka P, Lie RT, Havnen J et al. Avoidable stillbirths and neonatal deaths in rural Tanzania. Bjog.2003;110(6):616-623. Doi: https://doi.org/10.1046/j.1471-0528.2003.02153.x PMid:12798482

Waiswa P, Kallander K, Peterson S, Tomson G, Pariyo GW. Using the three delays model to understand why newborn babies die in eastern Uganda. Trop Med Int Health.2010;15:964-972. Doi: https://doi.org/10.1111/j.1365-3156.2010.02557.x PMid:20636527

Kidanto HL, Mogren I, van Roosmalen J, Thomas AN, Massawe SN, Nystrom L et al. Introduction of a qualitative perinatal audit at Muhimbili National Hospital, Dar es Salaam, Tanzania. BMC Pregnancy Childbirth. 2009;9:45. Doi: https://doi.org/10.1186/1471-2393-9-45 PMid:19765312 PMCid:PMC2754979

Government of India [www.gov.in]. National Portal of India: Maternal and child tracking system. Available from URL [Accessed on 8 january 2021]: https://www.india.gov.in/mother-and-child-tracking-system-mcts

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Published

2023-08-01

How to Cite

1.
H N HK, Baliga SB, Kushtagi P, Kamath N, Rao SS. Utility of Expert Panel to Identify Preventable Perinatal Deaths: Results from Audit Based Interventional Study in Two Districts of Karnataka State, India. Natl J Community Med [Internet]. 2023 Aug. 1 [cited 2024 Nov. 21];14(08):519-24. Available from: https://njcmindia.com/index.php/file/article/view/3157

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