We’re about six months into surveillance, and have audited 16 deaths, 15 of which were neonatal. When these deaths occur, a community volunteer calls our research team and we wait at least 2 weeks for grieving. Then, our audit forms are completed through 1:1 interviews with family of the deceased and anyone who provided care during the delivery. Those audits are compiled in a database, where we can get a snapshot of dozens of factors that could influence maternal and neonatal mortality.
Patterns we’re seeing so far include:
- Delivery occurring outside of a clinic
- 10 cases
- No skilled assistance
- 14 cases
- Lack of funding for transport or care reported in 3 interviews but possibly a more prominent issue
- Average distance between home and nearest facility: 15 KM
An opportunity we identified was that mothers in all cases reported receiving antenatal care.
This interaction could serve as an opportunity to educate patients on the importance of delivery with skilled assistance, early warning signs of active labor, and how to get to a nearby facility.
And new questions arose:
- Why do women deliver outside of the facility?
- Delays in decision making?
- What are our avenues for collecting this information?
- Add a question to the audit
- Ask mothers at CLI who have delivered at home
- Ask the mother during her prenatal visit how she plans to choose the location of her delivery
It seems inevitable that new questions will evolve and present themselves as we redefine our bigger initial questions: Why is maternal mortality so high in this area? What can be done about it? How would these improvements be made? But we’re narrowing in on the problem in order to identify a solution. A solution that would be generated with the culture and resource context necessary for lasting change.
See the Full MNM surveillance report