Risk identification from maternal and neonatal data for improvements in Quality of Care: A comparison of audit based approach with Maternal and Child Tracking System and Verbal Autopsy

Harsha  Kumar HN; Shantaram B  Baliga; Pralhad  Kushtagi; Nutan  Kamath; Sucheta S  Rao

doi:10.5455/njcm.20210710051306

Authors

Harsha Kumar HN Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
Shantaram B Baliga Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
Pralhad Kushtagi Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
Nutan Kamath Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
Sucheta S Rao Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India

DOI:

https://doi.org/10.5455/njcm.20210710051306

Keywords:

Maternal & Neonatal data, Risk Identification, MCTS, Verbal Autopsy, Audit Based Approach, Quality of care

Abstract

Background: Maternal and Child Tracking System (MCTS) and Verbal Autopsy (VA) are inadequate in risk identification from the available maternal and neonatal data. Hence community-based audit approach is required. Maternal and neonatal data obtained from MCTS, VA were compared with data obtained from the Audit model to know the differences in: (1) Quantity of information. (2) Relevance of the information.

Methods: Perinatal death auditing was conducted in two districts of Karnataka state with the help of an expert panel consisting of paediatricians and obstetricians. Information on perinatal deaths were received from hospitals as well as from the community. Data collection tool covered details pertaining to care received, transport, referral, apart from socio-demographic details. Medical Social Workers collected filled tools from the hospitals. Maternal and neonatal data of audit model was compared with that obtained from MCTS and VA.

Results: The data captured from audit model (n=1032) was more than MCTS (n=224) and VA (n=165) as it included the data from private hospitals and community. Maternal and neonatal risk identification was possible with audit system but not with MCTS and VA.

Conclusion: Audit system is comprehensive and provides inputs for health care planning.

References

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

Niti Aayog [internet]. Women and child development; [Cited 8 January 2021]. Available from: https://niti.gov.in/verticals/ women-and-child-development

Government of India [internet]. National Portal of India: Maternal and child tracking system; [Cited 8 January 2021]. Available from: https://www.india.gov.in/mother-and-child-tracking-system-mcts

Gera R, Muthusamy N, Bhulekar A, Sharma A, Singh P, Shekar A et al. An in-depth assessment of Maternal and Child Tracking System (MCTS) in Rajasthan and Uttar Pradesh. BMC Health Services Research (2015) 15:315.

Pallavan N, Jaya PT, Goel S. Is Mother and Child Tracking System on right track? An experience from Northern State of India. Indian J Public Health 2016; 60: 34-39.

Gaitonde R. Registration and monitoring of pregnant women in Tamil Nadu, India a Critique. Reprod Health Matter 2012; 20:118-124

Government of Karnataka [internet]. Department of Health and Family welfare: Mother and child tracking system; [Cited 8 January 2021]. Available from: http://karhfw.gov.in/mch/

Government of Rajasthan [internet]. Department of Medical Health and Family welfare: Pregnancy, child tracking and health service management system; [Cited 8 January 2021]. Available from: https://pctsrajmedical.raj.nic.in/private/ login.aspx

Government of Gujarat [internet]. Department of Health and Family welfare: Mother and child tracking system-e-Mamata; [Cited 8 January 2021]. Available from: https://e-mamta. gujarat.gov.in/

Government of Tamil Nadu [internet]. Directorate of Public health and preventive medicine: Pregnancy and Infant Cohort monitoring system; [Cited 8 January 2021]. Available from: https://picme.tn.gov.in/

National Family Health Survey [internet]. National Family Health Survey of India 4: Key Indicators; [Cited 8 January 2021]. Available from: http://rchiips.org/nfhs/factsheet_ nfhs-4.shtml

National Health Mission [internet]. Child Death Review: Operational guidelines August 2014; [Cited 8 January 2021]. Available from: https://nhm.gov.in/images/pdf/programmes/ child-health/guidelines/Operational_Guidelines_Child_Death_ Review.pdf

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

Pattinson R, Kerber K, Waiswa P, Day LT, Mussell F, Asiruddin SK et al. Perinatal mortality audit: counting, accountability, and overcoming challenges in scaling up in low- and middle-income countries. Int J Gynaecol Obstet. 2009;107(Suppl 1):S113–S121. S121-112.

Mancey-Jones M, Brugha RF. Using perinatal audit to promote change: a review. Health Policy Plan.1997;12(3):183–192.

Kate J Kerber, Matthews Mathai, Gwyneth Lewis, Vicki Flenady, Jan Jaap HM Erwich, TundeSegun 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

World Health Organization [internet]. Making every baby count: Audit and review of still births and neonatal deaths 2016; [Cited 8 January 2021]. Available from: https://www. who.int/publications/i/item/9789241511223

Dumont A, Fournier P, Abrahamowicz M, Traore M, Haddad S, Fraser WD. Quality of care, risk management, and technology in obstetrics to reduce hospital-based maternal mortality in Senegal and Mali (QUARITE): a cluster-randomised trial. Lancet.2013;382(9887):146–157.

Kidanto HL, Wangwe P, Kilewo CD, Nystrom L, Lindmark G. Improved quality of management of eclampsia patients through criteria based audit at Muhimbili National Hospital, Dar es Salaam, Tanzania. Bridging the quality gap. BMC Pregnancy Childbirth. 2012; 12:134.

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.

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.

Chigbu CO, Okezie OA, Odugu BU. Intrapartum stillbirth in a Nigerian tertiary hospital setting. Int J Gynaecol Obstet. 2009;104:18–21.

Van Roosmalen J. Perinatal mortality in rural Tanzania. Br J ObsteGynaecol. 1989; 96:827–834.

De Muylder X. Perinatal mortality audit in a Zimbabwean district. Paediatr Perinat Epidemiol.1989;3:284–293.

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. East Afr 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.

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.

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

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

Kumar H N H, Baliga 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. [Cited 8 January 2021]. Available from: https://www.ijmedph.org/ article/610