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Reducing perinatal mortality in developing countries.

D Wilkinson1

  • 1Centre for Epidemiological Research in South Africa, Medical Research Council.

Health Policy and Planning
|May 7, 1997
PubMed
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Implementing perinatal audit in rural Africa significantly reduced perinatal mortality rates by 40%. Measuring avoidable deaths proved crucial for evaluating healthcare quality improvements in resource-poor settings.

Area of Science:

  • Public Health
  • Healthcare Quality Improvement
  • Maternal and Child Health

Background:

  • Perinatal mortality rate (PNMR) is a critical indicator of health status, influenced by healthcare quality.
  • Evaluating interventions in healthcare services is challenging due to the absence of control groups.
  • Measuring avoidable perinatal deaths offers a method to assess intervention impact more rigorously.

Purpose of the Study:

  • To report the impact of perinatal audit on perinatal mortality in a rural African health district.
  • To evaluate the effectiveness of quality improvement interventions in reducing perinatal deaths.
  • To demonstrate the utility of measuring avoidable deaths for intervention assessment.

Main Methods:

  • A retrospective study of 21,112 births in a rural African health district from 1991 to 1995.
Keywords:
AfricaAfrica South Of The SaharaDelivery Of Health CareDemographic FactorsDeveloping CountriesEnglish Speaking AfricaHealthHealth FacilitiesHealth Services EvaluationHospitalsInfant MortalityMortalityNeonatal MortalityOrganization And AdministrationPopulationPopulation DynamicsProgram EvaluationProgramsQuality Of Health CareResearch ReportRural Health CentersSouth AfricaSouthern Africa

Related Experiment Videos

  • Implementation of perinatal audit to identify and address deficiencies in healthcare quality.
  • Measurement of perinatal mortality rate (PNMR) and the proportion of avoidable deaths.

    • Main Results:

    • The average number of monthly deliveries increased by 31% during the study period.
    • PNMR initially rose but then fell by 40% (p = 0.002), from 27/1000 in 1991 to 26/1000 in 1995.
    • The proportion of avoidable perinatal deaths decreased from 19% in 1991 to 0% by late 1995 (p = 0.0008).

    Conclusions:

    • Perinatal audit can significantly reduce mortality in resource-poor settings by improving healthcare quality.
    • Measuring avoidable deaths provides a more rigorous evaluation of interventions than PNMR alone.
    • Quality improvement initiatives are effective in reducing perinatal mortality even in challenging environments.