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Care Received by Migrant Women Who Died During or After Pregnancy: A National Confidential Case Note Review.

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Implementation assessment in confidential enquiry programmes: A scoping review.

Hemali Jayakody1, Marian Knight1

  • 1National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK.

Paediatric and Perinatal Epidemiology
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PubMed
Summary

Maternal death surveillance and response (MDSR) programs often lack methods to track how recommendations are implemented. This study highlights a critical gap in monitoring the effectiveness of maternal mortality reviews and calls for improved strategies.

Keywords:
confidential enquiryhealth carepeer reviewquality of health caresurveillance

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Area of Science:

  • Maternal Health
  • Public Health Surveillance
  • Healthcare Quality Improvement

Background:

  • Maternal Death Surveillance and Response (MDSR) programs are crucial for identifying avoidable factors in maternal deaths.
  • Confidential enquiries into maternal deaths generate recommendations to improve maternity care.
  • A significant gap exists in understanding how these recommendations are translated into practice.

Purpose of the Study:

  • To explore methods for assessing the implementation status of recommendations from confidential enquiries into maternal deaths.
  • To identify strategies for enhancing the response component of MDSR programs.

Main Methods:

  • A comprehensive literature search was conducted across major scientific databases (PubMed, Web of Science, CINAHL, Google Scholar) and grey literature.
  • The Arksey and O'Malley framework guided the search strategy.
  • Data extraction used a chart based on MDSR system components, followed by content analysis.

Main Results:

  • 13 confidential enquiry systems were reviewed; most published reports and recommendations, with dissemination often at national levels.
  • Only five reports detailed implementation strategies for their recommendations.
  • Routine follow-up of recommendations was documented in only two reports, and impact assessment on health outcomes was limited to the UK.

Conclusions:

  • There is a notable deficiency in monitoring the implementation and impact of recommendations from confidential enquiries into maternal deaths.
  • Development of robust monitoring mechanisms is essential for effective MDSR programs.
  • Further action is needed to bridge the gap between recommendations and their practical application in improving maternity care.