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The introduction of confidential enquiries into maternal deaths and near-miss case reviews in the WHO European region.
Reproductive Health Matters. 2007 Sep; 15(30):145-152.Most maternal deaths can be averted with known, effective interventions but countries require information about which women are dying and why, and what can been done to prevent such deaths in future. This paper describes the introduction of two approaches to reviewing maternal deaths and severe obstetric complications in 12 countries in transition in the WHO European Region - national-level confidential enquiries into maternal deaths and facility-based near-miss case reviews. Initially, two regional meetings involving stakeholders from 12 countries were held in 2004-2005, followed by national meetings in seven of the countries. The Republic of Moldova was the first to pilot the review process, preceded by a technical workshop to make detailed plans, provide training in how to facilitate and carry out a review, finalise clinical guidelines against which the findings of the confidential enquiry and near-miss case review could be judged, and a range of other preparatory work. To date, near-miss case reviews have been carried out in the three main referral hospitals in Moldova, and a national committee appointed by the Ministry of Health to conduct the confidential enquiry has met twice. Several other countries have begun a similar process, but progress may remain slow due to continuing fears of punitive actions against health professionals who have a mother or baby die in their care. (author's)
Workshop on Gender and Rights in Reproductive and Maternal Health, convened by World Health Organization, Regional Office for the Western Pacific, Kuala Lumpur, Malaysia, 28 November - 2 December 2005. Report.
Manila, Philippines. WHO, Regional Office for the Western Pacific, 2006 Mar. 40 p. ((WP)RPH/ICP/RPH/3.4/001/RPH(3)/2005-E; Report Series No. RS/2005/GE/43(MAA))More than a decade after the International Conference on Population and Development (ICPD) in 1994 and the Fourth World Conference on Women in 1995, governments are expressing their commitment to women's health, in particular to sexual and reproductive health. Unfortunately, high maternal and neonatal mortality remains a feature in many countries in the Western Pacific Region. The complex issues of reproductive and maternal health extend beyond technical and medical factors. Social determinants, such as gender and rights, though recognized as important factors in maternal mortality and morbidity, have not been considered in health services planning, perhaps because of a lack of understanding and inadequate capacity to operationalize the concepts. To achieve the Millennium Development Goals (MDG), it is essential that the gender and rights dimensions are fully understood and mainstreamed in policy, programmes and services. Recognizing the urgency of the situation, the WHO Western Pacific Regional Office decided to organize a workshop in collaboration with the Ministry of Health Malaysia as the host in Kuala Lumpur from 28 November to 2 December 2005. The Workshop on Gender and Rights in Reproductive and Maternal Health was the first ever organized by the Regional Office. Unlike other workshops, this was a training workshop aimed at introducing Concepts as well as some basics kills and tools to enable participants to bring a gender and rights perspective in to their programme services. (excerpt)
Verbal autopsies for maternal deaths. World Health Organization workshop, held at the London School of Hygiene and Tropical Medicine, 10-13 January 1994, London, U.K.
Geneva, Switzerland, World Health Organization [WHO], Division of Family Health, 1995. , 36 p. (WHO/FHE/MSM/95.15)The Safe Motherhood Programme of the World Health Organization convened a workshop in 1994 so that investigators from around the world could share their experience in the use of verbal autopsies (postmortem interviews of the relatives and/or neighbors of the deceased) to determine the cause of maternal death and move towards a consensus of what should constitute verbal autopsy methods. Workshop outcomes included the following: 1) a determination that the postmortem interview should consist of verbal autopsy, verbal determination of the nonclinical causes of death, and verbal reporting of background characteristics; 2) agreement that the classification of direct causes of maternal death may be single, dual, or a combination of single and multiple; 3) development of a comprehensive list of the signs and symptoms of obstetric/medical causes of maternal death (direct and indirect); 4) agreement that verbal autopsies should be conducted for all deaths of women of reproductive age to determine early pregnancy deaths; 5) determination that the future development of flowcharts would be valuable for identifying and coding causes of maternal death; 6) identification of information to be included in all questionnaires; and 7) consideration of specific aspects of data collection (requirements for interviewers, respondents, getting information from health providers, the recall period, and validation of specific aspects). Appended to this report are 1) a list of participants, 2) flowcharts for causes of maternal death, 3) suggestions for questions to be asked, 4) suggestions for a questionnaire, and 5) a summary of selected studies that used lay reporting to identify causes of death.