For a bet­ter neona­tal care

Bhutan Times - - Editorial -

Our coun­try doesn’t have guide­line on proper record­ing on ma­ter­nal, peri­na­tal and neona­tal death (MPND) now but by 2018, there will be guide­lines for a proper record­ing sys­tem.

Although ma­ter­nal neona­tal death rate 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 re­cently.

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

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.

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 where deaths have oc­curred.

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.

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 Na- tional 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.

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.

As this is go­ing to be an im­por­tant ex­er­cise to find out the rea­sons for the ma­ter­nal, peri­na­tal and neona­tal death in the coun­try, the guide­lines should be well tested with the chang­ing times in or­der to pro­vide our pol­icy mak­ers with all facts and fig­ures to en­able them to take ap­pro­pri­ate de­ci­sions with will have a long im­pact in im­prov­ing the life of our in­fants.

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