Table 3.
Mortality, morbidity and process of care outcomes*
| Author/year | Mortality perinatal, neonatal and stillbirths |
Morbidity (neonatal, perinatal and maternal | Standard of care | Other process outcomes |
| Stratulat, 201419 | Proportional mortality rates among fetuses/ newborns with a gestational age of ≥37 weeks and with a birth weight of ≥2500 g for the years 2005–2013. The proportional mortality rate decreased from 5.1 per 1000 in 2006 to 3.6 per 1000 in 2013 (with 1.5 per 1000 or 29.4% reduction, 95% CI 0.6 to 2.4; z-value 3.2; p=0.0015). | Improvements in the standards of care through multidisciplinary audit sessions and a no-blame approach Improved management of cases (breech presentation, cord pathology and Intrauterine growth retardation monitoring) | Improved birth records partograph updated and modernised Improved documentation tools for perinatal deaths partograph used correctly and appropriate Improved clinical decision making for complicated cases from 44% in 2007 to 82% in 2010 Recognised the role of other professionals (social workers and psychologist) in preventing perinatal deaths strengthened collaboration across borders |
|
| Nakibuuka, 201222 | The overall perinatal mortality rate in 2008 was 47.9 compared with 52.8 per 1000 total births in 2007 | _ | _ | _ |
| Kidanto, 200920 | _ | _ | _ | Improved referral system to reduce delays Improved documentation |
| Kasengele, 201721 | _ | Obstructed labour accounted for 55.7% (n=64) in the initial audit and 38.7% (n=12) in the reaudit Antepartum haemorrhage accounted for 23.5% (n=27) at baseline and 16.1% (n=5) at re-audit. Unknown causes increased from 14.8% (n=17) in the initial audit to 38% (n=12) in the reaudit. |
Increases occurred in: Partograph usage (from 36 (31.3%) to 20 (65%)) All Severe pre-eclampsia/eclampsia cases received correct treatment of magnesium sulphate at both initial and reaudit referral of women with obstructed labour (31 (48%) to 11 (92%)); women catheterised (22 (38%) to 7 (58%)); women reviewed within 15 min (2 (3%) to 4 (33%)); C/S operating staff notified (31 (37%) to 16 (100%)); C/S done within 10 min (31 (37%) to 12 (78%)) |
*Table tampelate was adapted from reference.27
C/S, Caesarean Section; Dash (-), not reported.