Study on Infant & Maternal

Death Audit in Haryana

Presentation prepared by

Mr. Vivek SharmaSr. consultant M&E, PHPHSHRC, Panchkula

Dr. Meenakshi Gupta,Consultant M&E,HSHRC, Panchkula

Date: 5th April 2013Venue: SIHFW, Panchkula

Why is this study needed?What do you think? Is this study needed?

INTRODUCTION

Verbal autopsy is a research method that helps to determine probable causes of death in cases where there was no medical record or formal medical attention given.

Verbal autopsy offers a solution to the challenge of generating cause of death information.

NEED OF VERBAL AUTOPSY ....

Verbal autopsy asks about signs and symptoms of the deceased person, risk factors and health care seeked prior to death, clarifying social, economic, behavioral, and health system issues that may have contributed to death.

This contextual knowledge is invaluable to health care managers, planners, communities, researchers, and policy & decision makers.

PROCESS OF MATERNAL AND INFANT DEATH AUDIT IN HARYANA

Line listing of all Deaths (reported

by ANM/ASHA)

Separation of women deaths aged between 15-44 years

Screening of suspected Maternal Deaths (by MO)

Community based MDR (Verbal Autopsy, of all MD)

& or Facility based MDR

Review of Maternal Death at Block and district level (monthly)

Review of MD at state level (quarterly/bi-annually)

Separation of deaths aged between 0-1

year

Death audit of all infant Deaths

IDR at block/district/state level

CHALLENGES OR GAPS IN THE PROCESS(EXPERIENCE FROM OTHER STATES)

Very little motivation of the service providers to conduct sincere audit

Case sheets are rewritten (facility based)

Supervisory officers tend to protect their subordinates

Reviews are more in favour of protecting the service providers rather than finding out the lapses in the provision of care

CHALLENGES OR GAPS IN THE PROCESS …(EXPERIENCE FROM OTHER STATES)

Blame is often put on the field health functionaries

Non medical causes / contributory factors not identified

Timely conduct verbal autopsy at community and facility level

Compilation and analysis of verbal autopsy data and review of report at the facility, district, and state level

Action taken report

CAUSES OF MATERNAL DEATH

Obstructed Labour

1%

Sepsis8%

Hyper-tension

6%

Haemor-

rhage30%

Other55%

Causes of maternal deaths in Haryana,

2012

N = 294Reported Maternal

DeathsSource: Dept. of Health & Family Welfare, Haryana, 2012

IndicatorIndia (Current)

*SRS RGI

Haryana (Current)*SRS RGI

MDG2015

Infant Mortality Rate 44 44 <30

Maternal Mortality Rate 212 153 <100

CURRENT STATUS OF IMR & MMR AND COMPARE WITH MDG GOAL

STUDY FOCUS

Find out challenges and gaps in

process of MDR & IDR

Back check of existing review

reports (verbal autopsies)

Corrective measures to conduct

and review Maternal & Infant

Deaths

THANK YOU