Practice of death surveillance and response for maternal, newborn and child health: a framework and application to a South African health district.

摘要: Objective To assess the functioning of maternal, perinatal, neonatal and child death surveillance response (DSR) mechanisms at a health district level. Design A framework elements covering analysis causes death, processes review was developed applied to smallest unit coordination (subdistrict) evaluate DSR functioning. The evaluation design descriptive qualitative case study, based on observations practices interviews. Setting Rural South African (subdistricts office). Participants purposive sample 45 front-line managers providers involved with DSR. reviewed included system real-time reporting (24 hours) (48 hours), nationally mandated confidential enquiry into maternal regular facility subdistrict mortality audit processes. Primary outcome measures Functioning Results While were integrated organisational routines district, their varied across subdistricts between forms Some DSR, notably those involving deaths, external accounting, more likely trigger reactive fault-finding sanctioning than other forms, which proactive in supporting evidence-based actions prevent future deaths. These occurred provider level, limited extent, communities. Conclusions This study provides an empirical example everyday practice It assesses such enabling that may be value similar settings elsewhere.