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Maternal near-miss surveillance, Namibia.
Steffie Heemelaar1, Mirjam Josef1, Zoe Diener2
1Department of Obstetrics & Gynaecology, Katutura State Hospital, PO Box 86237, Eros, Windhoek, Namibia.
Bulletin of the World Health Organization
|August 11, 2020
Summary
Maternal near-miss surveillance in Namibia identified key challenges in maternity care, including access to C-sections. This data helps tailor interventions to improve maternal outcomes.
Area of Science:
- Public Health
- Obstetrics & Gynecology
- Health Systems Research
Background:
- Maternal mortality remains a significant global health challenge.
- Effective maternal care systems require robust data for targeted improvements.
- Near-miss surveillance offers insights into preventable maternal morbidity and mortality.
Purpose of the Study:
- To implement and evaluate maternal near-miss surveillance in Namibia.
- To identify challenges and benefits of near-miss data collection in a low-resource setting.
- To inform policy and program development for enhanced maternal healthcare.
Main Methods:
- Adapted World Health Organization (WHO) near-miss criteria for the Namibian context.
- Conducted training for healthcare staff across 35 participating facilities.
- Performed facility visits for data verification and staff feedback post-implementation.
Main Results:
- Recorded 298 maternal near misses (8.0/1000 live births) and 23 maternal deaths over 6 months.
- Obstetric hemorrhage and hypertensive disorders were leading causes of near misses.
- Poor neonatal outcomes observed, with only 50.3% of infants returning home with mothers.
Conclusions:
- Maternal near-miss surveillance is effective for identifying in-country healthcare system challenges.
- Identified challenges include limited access to essential interventions like caesarean sections.
- Findings support the development of targeted, locally relevant interventions to improve maternal health outcomes.