Improving Facility-based Maternal and Neonatal Health Surveillance Systems in Haiti Open Access

Abstract

Haiti's current health system does not accurately identify and collect information related to maternal deaths and pregnancy outcomes. As a result, the Centers for Disease Control and Prevention's Health System Recovery Team (HSRT), in collaboration with Haiti's Ministère de la Santè Publique et de la Population (MSPP) is currently working to strengthen the existing surveillance system and improve the quality of maternal care. To expand upon current efforts to identify and reduce maternal mortality, HSRT now wants to link maternal and neonatal outcomes and monitor the impact of its programs throughout the continuum of care, with the goal of identifying areas for intervention. As neonatal health is closely linked to ante- and intra-natal care, understanding the relationship between neonatal and maternal outcomes is crucial to determining the current state of reproductive health as well as the impact of HSRT programming. Without a strong vital registration and neonatal register system, it is difficult to identify patterns in maternal and neonatal outcomes and therefore develop approaches that can help to mitigate the high maternal mortality and neonatal deaths currently experienced in Haiti, 380 per 100,000 live births and 31 per 1,000 births respectively. In an effort to better inform MSPP of the case burden of neonatal morbidity as well as neonatal mortality, this special studies project, identifies areas for improvement within exciting data collection process and quality. Based on key informant interviews and line-listing registries collected at 3 Haitian health facilities in December 2014, areas for improvement were identified, best practices were determined and a detailed implementation plan was created. The detailed implementation plan includes the program framework, timeline and details on activities. This plan will be used by CDC/MSPP in piloting an improved neonatal surveillance program in 2 Haitian facilities.

Table of Contents

Glossary. i

Chapter I: Introduction. 1

Chapter II: Literature Review. 9

Improving Maternal and Child Health in Haiti. 9

History of Maternal and Child Health Funding in Haiti .9

Best Practices for Maternal and Neonatal Registries. 14

Application of MCH registry programming. 15

Chapter III: Methods. 19

Research design. 21

Plans for data analysis. 23

Ethical Considerations. 23

Chapter IV: Results. 25

Pediatric Registry. 27

Data Collection Processes. 28

Chapter V: Discussion. 32

Appendix A: Data Collection Flow Charts. 38

Appendix B: WHO recommendation for Postnatal visits. 41

Appendix C: Deliverable. 42

Project Framework. 51

Activity Details. 52

Appendix D: Neonatal Transfer form. 55

Appendix E: Neonatal Checklist. 56

Appendix E: Timeline. 59

Bibliography. 60

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Surveillance Maternal Health Haiti
Committee Chair / Thesis Advisor	McFarland, Deborah A, Emory University
Committee Members	Widiastuti, Endang, Centers for Disease Control and Prevention
Partnering Agencies	CDC

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