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Perinatal audit using the 3-delays model in western Tanzania
Godfrey Mbaruku1, Jos van Roosmalen, Iluminata Kimondo
1Department of Obstetrics and Gynaecology, Regional Hospital, Maweni, Kigoma, Tanzania.
Objective:
To audit intrapartum fetal and early neonatal deaths of infants weighing >or=2000 g in a regional hospital in western Tanzania.
Methods:
The 3-delays methodology was applied to a cohort of perinatal deaths from July 2002 to July 2004.
Results:
The overall perinatal mortality rate in the hospital was 38 per 1000 live births, and in just over half of these cases the birth weight was >or=2000 g. The leading clinicopathologic causes of death were birth asphyxia (19.0%), prolonged or obstructed labor (18.5%), antepartum hemorrhage (11.5%), and uterine rupture (9.0%). First delays occurred in 19.0% of the cases, second delays occurred in 21.5%, and third delays occurred in 72.5%.
Conclusion:
For women who delivered in this hospital, most of the substandard care occurred after admission to the health facility. The improvement of institutional health care may have a significant impact on the decision to attend health institutions and, thereby, reduce first delays.
