Coun­try will have proper guide­line on record­ing of MPND

Bhutan Times - - Home - Sonam Pen­jor

To­day the coun­try doesn’t have guide­line on proper record­ing on ma­ter­nal, peri­na­tal and neona­tal death (MPND) but by 2018, there will be guide­line to have proper record­ing sys­tem.

Although MNDR is con­ducted quar­terly in the dis­tricts and an­nu­ally at the na­tional level, but lacks proper guid­ance/ guide­line., “Ap­praisal on ma­ter­nal peri­na­tal and neona­tal death sur­veil­lance and re­sponse (MPNDSR) guide­line 2016” was pre­sented dur­ing the 4th Bi­en­nial Health Con­fer­ence which ended yes­ter­day.

The ob­jec­tives of the MPNDSR guide­line was to no­ti­fied of Ma­ter­nal, Peri­na­tal and Neona­tal Deaths and Re­port­ing of Ma­ter­nal, Peri­na­tal and Neona­tal Deaths.

Pema Lethro, Pro­gram Of­fi­cer un­der Depart­ment of Pub­lic Health pre­sented that MPNDSR is a form of con­tin­u­ous sur­veil­lance link­ing the health in­for­ma­tion sys­tem and qual­ity im­prove­ment pro­cesses from lo­cal to na­tional lev­els.

It in­cludes the rou­tine iden­ti­fi­ca­tion, no­ti­fi­ca­tion, quan­tifi­ca­tion, and de­ter­mi­na­tion of causes and avoid­abil­ity of all peri­na­tal, neona­tal and ma­ter­nal deaths, as well as the use of this in­for­ma­tion to re­spond with ac­tions that will pre­vent fu­ture deaths.

Pema Lethro said that Vil­lage Health Worker (VHW) and Tshogpa/ Gup should iden­tify and no­tify deaths to near­est health cen­ter within 48 hours.

He added that in the ab­sence of VHW, Tshogpa and Gup should no­tify and re­port sus­pected ma­ter­nal, peri­na­tal and neona­tal deaths in the com­mu­nity to DHO/near­est health cen­ter through the sms/call.

In­ves­ti­ga­tion should be car­ried out only after 21 days of the in­ci­dent. The in­ves­ti­ga­tion and re­port­ing to the RMNHP Pro­gram should be done as in health fa­cil­ity deaths.

So he said that they need to acted on the lo­cal level, we should not al­ways come to the cen­tral agen­cies. “Any­thing hap­pened at the lo­cal level should be acted upon it.”

Then dis­trict health of­fi­cer (DHO) or in­sti­tu­tional head should con­duct re­view, anal­y­sis, make rec­om­men­da­tion and re­sponds and sub­mit re­port to the pro­gram quar­terly in­clud­ing zero re­port­ing.

He also added that then In­charge should iden­tify and no­tify deaths within 24 hours to DHO/ RMNHP. “This is what we have been do­ing yet we are go­ing to in­sti­tuted.”

The guide­line also in­cludes that it should also de­ter­mine death dur­ing the preg­nancy or 42 days after the ter­mi­na­tion of preg­nancy.

Then each health fa­cil­ity in­clud­ing Na­tional and Re­gional Re­fer­ral Hos­pi­tals, Mil­i­tary Hos­pi­tals should re­port deaths to the DHO monthly by 7th of the fol­low­ing months in the pre­scribed forms. Even in the ab­sence of deaths, zero re­port­ing should be done.

Fi­nally the DHO should com­pile and sub­mit com­plete re­port to the Re­pro­duc­tive, Ma­ter­nal and Neona­tal Health Pro­gram quar­terly on 15th of the first month of the fol­low­ing quar­ter.

Since the main causes of death of ma­ter­nal, peri­na­tal and neona­tal, he added that line list­ing of all preg­nant women and track­ing them is the key. All health cen­ters should line list preg­nant women in the com­mu­nity and col­lect in­for­ma­tion about out­comes of preg­nancy.

How­ever, all deaths ( ma­ter­nal, peri­na­tal or neona­tal) that oc­cur on en- route, re­port­ing should be done by the re­fer­ring hos­pi­tal.

And, all deaths ( ma­ter­nal or neona­tal) that oc­cur in the higher health fa­cil­ity for all re­ferred cases should be re­ported by the higher health fa­cil­ity.

Also all deaths ( ma­ter­nal or neona­tal) where the death oc­curs en route from home to health fa­cil­ity should be re­ported as com­mu­ni­ty­based death.

In­ves­ti­ga­tion team should col­lect the in­for­ma­tion on causes of deaths which in­clude so­cio- eco­nomic and cul­tural fac­tors, ac­ces­si­bil­ity of fa­cil­i­ties, and qual­ity of care.

Mean­while, the 4th Bi­en­nial Health Con­fer­ence (BHC), with the theme “En­hanc­ing col­lab­o­ra­tion, co­or­di­na­tion and con­sol­i­da­tion in the health sec­tor” con­cluded with the adop­tion with the adop­tion of 26 rec­om­men­da­tions on im­prov­ing health ser­vice de­liv­ery in the coun­try.

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