In Kenya, E4A-Mama Ye supports strengthening MPDSR in five high volume hospitals, including the Mama Lucy hospital at the heart of Nairobi City County. In April, I had the chance to visit the Mama Lucy facility and meet the team implementing MPDSR.
When talking with Dr Muta, the resident gynecologist, and the rest of the team, it was exciting to hear how strongly they felt about their experience as part of the MPDSR Committee at Mama Lucy, and to hear them talk about the progress made so far.
Kenya is among the top 10 countries in the world with highest burden of maternal mortality, losing between 5000 to 6000 mothers every year due to pregnancy and birth related complications. To see improvements in maternal and perinatal mortality there needs to be accurate review of the number and causes of death. Collecting this information is essential to decide what action to take to prevent similar deaths happening in the future. MPDSR focuses on linking information and response, ensuring response are taken based on data to prevent avoidable maternal and perinatal mortality happening in the future.
Improving MPDSR system at Mama Lucy hospital
Before the introduction of the MPDSR concept and implementation of MPDSR guidelines, Mama Lucy had no systematic way of reviewing maternal and perinatal deaths. All this changed in October 2017, when staff established an MPDSR committee that would be responsible for the tracking and reporting of maternal and perinatal deaths. The committee put in place monthly meetings focused on reviewing the cases and looking at responses to the gaps identified.
It was clear when speaking with members of the MPDSR committee, that MPDSR has brought about a positive change in attitude at the hospital, with staff increasingly engaged and taking action to prevent future deaths: “When everyone is engaged, it’s easier to make the change happen”. Key to this change has been the creation of a “no name, no blame” environment – a cornerstone of MPDSR – and critical for staff taking ownership of the process and sharing their insights and findings.
It’s not about making someone responsible for something that happened; it is about understanding the reasons why that happened and why that can contribute to improving the hospital’s performance for the health of mothers and babies.
Dr Mutua, Hospital Gynecologist Mama Lucy is an example of successful implementation and institutionalization of MPDSR, thanks to continuous and ongoing efforts of all staff to sharing relevant information and ensuring regular audits and feedback are in place. Right now, the hospital claims to have a 100% maternal death reporting.
However, while some great progress has been made at Mama Lucy, we also openly discussed the issues that still need to be addressed. Members of the MPDSR Committee talked of how it is harder to implement perinatal deaths reviews and subsequent actions and that more effort is needed in this area. Technology also represents a big challenge when it comes to sharing best practices on causes of death. Often the same hospital can have trouble accessing the information systems that collects the data and there is little to no sharing of information between MPDSR committees in different facilities.
How policy-makers can help the change happen
The visit to Mama Lucy hospital, provided me with first-hand experience of how MPDSR can impact people’s lives. At E4A-MamaYe, we know that maternal and perinatal surveillance and response is an important tool for strengthening health systems. When doctors, nurses, and health workers have the data they need and use this to make decisions about healthcare provision everyone benefits.
We call on the government of Kenya to continue supporting the implementation of MPDSR across the country, ensuring the full implementation of the National Guidelines and empowering all levels of the health system to make changes to prevent future avoidable maternal and perinatal deaths.