Synergy Between Emergency Obstetric and Neonatal Care and Maternal Death Surveillance and Response in Haiti Pre- and Post-Crisis Analysis Report Open Access

Mahgoub, Gihad (2016)

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In a poor and disaster-prone country like Haiti, maternal and child health (MCH) indicators are far below other Caribbean and Latin countries. Maternal mortality ratio (MMR) in Haiti is the highest in the Western Hemisphere reaching 359 deaths per 100,000 live births in 2015 according to the Maternal Mortality Estimation Interagency Group . Studying MMR and understanding the root causes before and after the devastating 2010 earthquake, identifies gaps that can inform recommendations, strategies, and interventions to decrease mortality while improving maternal and child health in Haiti for future. This special studies project aims to provide an overview of the provision of emergency obstetric and neonatal care (EmONC) and examine how it could be linked with strengthening the maternal death surveillance and response (MDSR). It is assumed that strong linkages between these services and systems, working effectively together, will contribute towards the reduction of MMR in Haiti.In order to understand this, data from 2013 (three years of post earthquake) in 2 facilities; Hôpital Albert Schweitzer (HAS) Sacré Coeur De Milot (SCM) was reviewed, discussed, and recommendations provided in this report. Results/Finding Reliable surveillance system informs the national strategy and interventions as it is proven to achieve better health outcomes. MDSR specifically involves community participation and surveillance, which ensures promotion of the underutilized services in EmONC facilities and provides the most accurate data that informs upgrading and enhancing the quality of services. Main Recommendation and Conclusion Developing a joint strategy applying both MDSR and EmONC would increase the efficiency of surveillance and reporting improving the cycle of service provision. This joint program should be piloted in EmONC facilities, the surrounding communities, and provide trainings to health care providers on verbal autopsy, as well as other key best practices. A community-based surveillance system that engages with service providers and the wider surveillance system will ensure quality data collection and analysis.

Table of Contents

1. Introduction

1.1. Background and Rationale

1.2. Situation Analysis

1.3. CDC Support to MSPP in Haiti

2. Literature Review

2.1. Neonatal and Maternal Deaths in Haiti

2.1.1. Major Causes

2.1.2. Social Determinants

2.1.3. Health Disparities in Coverage and Distribution of MCH and EmONC Services

2.1.4. Health Care Service-related Factors Affecting MMR Availability of Quality Services Health System Infrastructure Health Care Service Providers Accessibility of Health Care Services 2.1.5. Government Strategies and Interventions to Reduce MMR

2.2. Maternal Death Surveillance and Response in Haiti 2.2.1. National Surveillance System

2.2.2. Objectives of MDSR

2.2.3. Evaluation of Surveillance Effectiveness

2.2.4. Challenges/Barrier and Opportunities

3. Methods

3.1. Data Collection

3.2. Data Analysis

3.3. Ethical Considerations

3.4. Limitations

4. Synthesis

4.1. EmONC Overview

4.2. MSPP Assessment 2013

4.3. MDSR Overview

4.4. Discussion

4.5. Conclusion and Recommendations

5. Bibliography

6. Appendices

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