Nairobi implements guidelines to cut maternal deaths

Maternal and Perinatal Deaths Surveillance and Response (MPDSR) system traces the circumstances surrounding every maternal death in the County. [Courtesy]
A new system to audit deaths of new mothers and babies before or soon after birth have been credited with saving lives in the last one year.

Embraced by Nairobi County last year, the Maternal and Perinatal Deaths Surveillance and Response (MPDSR) system traces the circumstances surrounding every maternal death.

The system seeks to stop blame games by suggesting solutions to pre-empt more deaths.

A report dubbed First Confidential Inquiry into Maternal Deaths in Kenya, launched early this year, said four of every five new mothers who die in hospital receive poor care.

With this in mind, the Nairobi County health department is enforcing the MPDSR system.

“The national MPDSR guidelines are meant to stop the culture of blame game whenever a new mother dies,” says Nimo Hussein, an MPDSR technical associate for Nairobi County.

Carol Ngunu, the deputy director of health, said the system built on the causes of every maternal death to prevent further loss of lives. 

“We look at the reasons a mother or newborn has been lost and seek to use every case as a learning experience,” says Dr Ngunu.

Lessons learnt under the new guidelines have seen the county improve its ambulance system and procurement of better communication gadgets for emergency responders.

Audit committees

The MPDSR involves setting up committees at different levels to audit the cause of every maternal death.

The committee's job is to answer the question: What went wrong and at what point?

Each death is audited separately and at the end, the committee comes up with action points to prevent further deaths from similar causes.

“Every maternal death is followed by an audit to find out why it occurred and the response needed to prevent another death,” says Esther Kiambati, the county reproductive health coordinator

The system is structured in a way that health workers do not fear recrimination when a complication occurs but instead offer insights into what caused it.

“For instance, a mother may die because she has lost a lot of blood during delivery. We try to find out why she was not transfused. We keep probing until we find what went wrong,” said Ms Kiambati.

The system is based on research showing that 80 per cent of maternal and perinatal deaths are preventable.                                                         

The committees meet at different levels, beginning at the community level to the county level.

If, for example, the death happened before the mother reached hospital, then the committee at the community level sits to find out what went wrong.

Community action

“It could be that labour pains started at night and due to insecurity, the mother could not leave the house. Then community acts to ensure this it does not happen again,” says Kiambati.

The results of the system have been encouraging. For starters, it has seen health workers open up on causes of maternal deaths.

“Nowadays they do not hide any details,” says Kiambati.

Above all, it is has saved lives, the number of which the county is currently working to establish.

“We have seen less numbers of maternal deaths and are working on the exact statistics," said Mahat Jimale, the county chief officer of health.

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MPDSRFirst Confidential Inquiry into Maternal Deaths in KenyaNairobi County