Making Every Baby Count

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4.16.2 During the last 3 months of pregnancy but before labour, how often were (you – if mother is the respondent; or the mother – if other respondent) down, depressed or hopeless? 4.17 How many births, including stillbirths, did the mother have before this baby? COUNT ALL BABIES BORN ALIVE OR DEAD AT OR AFTER 7 MONTHS OF PREGNANCY; DO NOT COUNT THE BIRTH OF THE BABY WHO DIED 4.18 How many of these previous births were stillbirths? BORN DEAD AFTER 7 MONTHS OF PREGNANCY 4.19 Now, let’s talk about the birth of the baby who died. How many weeks or months was the mother pregnant when the baby was born? TRY TO RECORD IN WEEKS, WHENEVER POSSIBLE NOT AT ALL....................................................................1 SEVERAL WEEKS............................................................2 MORE THAN HALF OF THE TIME (OF 3 MONTHS) ....3 NEARLY EVERY DAY.......................................................4 DON’T KNOW................................................................8 NUMBER OF BIRTHS................................... DON’T KNOW.............................................................. 98 NUMBER OF STILLBIRTHS.......................... DON’T KNOW ............................................................. 98 WEEKS............................................................................1 OR MONTHS........................................................................2 DON’T KNOW ........................................................... 998 4.20 Was the baby born before expected? YES.................................................................................1 NO .................................................................................2 DON’T KNOW ...............................................................8 4.20.1 How many days, weeks or months was the baby born before the expected date of delivery? DAYS...........................................................1 ENTER IN DAYS OR WEEKS OR MONTHS OR WEEKS........................................................2 OR MONTHS....................................................3 DON’T KNOW............................................................ 998 4.21 Was the baby a single or multiple birth? SINGLETON...................................................................1 TWIN .............................................................................2 TRIPLET OR MORE.........................................................3 DON’T KNOW................................................................8 4.21.1 What was the birth order of the baby that died, in the case of a multiple birth? 4.21.2 Before the birth of this baby (babies, if twin delivery), when did the woman have her previous pregnancy (dd/mm/yyyy)? RECORD “98” IF DON’T KNOW DAY OR MONTH RECORD “9998” IF DON’T KNOW YEAR RECORD “77” FOR MONTH AND “7777” FOR YEAR IF NO PREVIOUS PREGNANCY 4.21.3 What was the outcome of the last pregnancy before this baby? CIRCLE “7” IF THE BABY WHO DIED WAS THE FIRST PREGNANCY FIRST..............................................................................1 SECOND ........................................................................2 THIRD ............................................................................3 OTHER (SPECIFY) _____________________________ 4 DON’T KNOW................................................................8 DAY.................................................................. MONTH........................................................... YEAR................................................... SINGLE LIVE BIRTH.......................................................1 MULTIPLE BIRTH (ALL ALIVE) ......................................2 MULTIPLE BIRTH (ONE ALIVE) .....................................3 MULTIPLE BIRTH (ALL DEAD) ......................................4 SINGLE STILLBIRTH......................................................5 ABORTION.....................................................................6 NO PREVIOUS PREGNANCY.........................................7 DON’T KNOW................................................................8 4.21 4.21 4.21.2 4.21.2 116 MAKING EVERY BABY COUNT: AUDIT AND REVIEW OF STILLBIRTHS AND NEONATAL DEATHS
SECTION 5. DELIVERY HISTORY 5.1 Where was the baby born? OWN HOME ................................................................ 01 TBA’S WORK AREA/HOME .......................................... 02 ENROUTE TO HOSPITAL/HEALTH FACILITY.............. 03 PUBLIC SECTOR HEALTH CARE GOVERNMENT HOSPITAL........................................... 04 GOVERNMENT HEALTH CENTRE ............................... 05 OTHER PUBLIC SECTOR (SPECIFY) _____________ 06 PRIVATE SECTOR HEALTH CARE PRIVATE HOSPITAL/CLINIC......................................... 07 OTHER PRIVATE SECTOR (SPECIFY) _____________ 08 OTHER (SPECIFY) ____________________________ 77 DON’T KNOW.............................................................. 98 5.1.1 How soon after labour started did she receive assistance with labour and delivery? IF THE ANSWER IS IN DAYS: ESTIMATE NUMBER OF HOURS HOURS......................................................... DID NOT RECEIVE ASSISTANCE.................................. 20 INDUCTION OF LABOUR FOR FETAL DEATH............. 55 INDUCTION OF LABOUR/ POSTDATE BABY.............. 66 NO LABOUR, PLANNED C-SECTION........................... 77 DON’T KNOW.............................................................. 98 5.2 Who assisted the delivery? DOCTOR.........................................................................1 CLINICAL OFFICER/MEDICAL ASSISTANT....................2 NURSE............................................................................3 MIDWIFE .......................................................................4 TRADITIONAL BIRTH ATTENDANT...............................5 RELATIVE .......................................................................6 MOTHER BY HERSELF ..................................................7 OTHER (SPECIFY) _____________________________ 8 DON’T KNOW................................................................9 5.3 How many hours or days was she in labour before delivery? IF LESS THAN 1 HOUR, RECORD “00” IN HOURS IF RESPONDENT DOESN’T KNOW, ASK IF THE MOTHER HAD BEEN IN LABOUR > 24 HOURS BEFORE DELIVERY. 5.3.1 Was the mother given any medication during labour to stimulate contractions? If yes, please specify 5.3.2 Do you know whether the mother used local herbs during pregnancy, labour and delivery, or after delivery (in relation to this last pregnancy)? READ ALL RESPONSE OPTIONS EXCEPT “DON’T KNOW” 5.4 When did the water break? READ OPTIONS HOURS.......................................................1 OR DAYS...........................................................2 MORE THAN 24 HOURS ........................................... 777 DON’T KNOW ........................................................... 998 YES (SPECIFY) ________________________________ 1 NO..................................................................................2 DON’T KNOW................................................................8 DURING PREGNANCY BUT BEFORE LABOUR .............1 DURING LABOUR AND DELIVERY................................2 AFTER DELIVERY............................................................3 DURING PREGNANCY AND LABOUR/DELIVERY..........4 DON’T KNOW................................................................8 Before labour started?.....................................................1 OR During labour? ...............................................................2 DON’T KNOW ...............................................................8 5.7 BORN ASSI HLAB MAKING EVERY BABY COUNT: AUDIT AND REVIEW OF STILLBIRTHS AND NEONATAL DEATHS 117
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Making Every Baby Count Audit and r
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Making Every Baby Count Audit and r
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4.3 The six-step mortality audit cy
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Acknowledgements The World Health O
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Foreword Pregnancy is a time of gre
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in the future. The process of routi
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Key messages of this guide • Audi
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1 Getting started
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1.2 Why is this guide important? Co
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Importantly, it is not sufficient t
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2 Definitions and classification Th
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There are also numerous ways to app
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TABLE 2.1. Mortality rate definitio
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application of ICD-10 to deaths dur
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Box 2.1. Background and contextual
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• Family- or patient-related: e.g
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3 Auditing deaths that occur at the
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Within each facility, at least two
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compared to the actual numbers of r
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of events that led to death, text b
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• the number of antepartum (or ma
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Possible actions include interventi
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Step 6: Evaluating and refining The
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4 Auditing deaths that occur in the
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(e.g. individuals who conduct routi
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The most effective mechanism for in
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Step 1.2: Notification and reportin
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It may be easier for an information
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Geospatial analyses may be very ben
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5 Creating an enabling environment
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will help facilitate the process fo
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Maternal and Perinatal Death Review
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6 Scaling up audit for quality and
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FIGURE 6.1. Dimensions of a phased
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FIGURE 6.2. Example of data flow in
Page 72 and 73: References 1. Maternal death survei
Page 74 and 75: 39. Bradshaw D, Chopra M, Kerber K,
Page 76 and 77: Annexes Annex 1 Stillbirth and Neon
Page 78 and 79: 3.6 Fetal heart sounds on admission
Page 80 and 81: Annex 1b. Guidance for completing t
Page 82 and 83: • “unknown” if the total numb
Page 84 and 85: • If fetal heart sounds were not
Page 86 and 87: -- If a “delay 1” is present, c
Page 88 and 89: . antepartum complications Annex 2:
Page 92 and 93: 2.1b: Cause of death - intrapartum
Page 94 and 95: Annex 3b. Guidance for collecting t
Page 96 and 97: 3) If there is no gestational age e
Page 98 and 99: Annex 4. Approaches for classifying
Page 100 and 101: There are multiple tools available
Page 102 and 103: to their occurrence - are entered o
Page 104 and 105: Annex 6. Sample mortality audit mee
Page 106 and 107: Annex 8: Stillbirth and Neonatal Mo
Page 110 and 111: Steps 1. Understand the steps of th
Page 112 and 113: INFORMED CONSENT FORM (INTERVIEWEE
Page 114 and 115: SEQUENTIAL NUMBER SECTION 1. INTER
Page 116 and 117: SECTION 3. INFORMATION ON THE DECEA
Page 118 and 119: ASK THE RESPONDENT: What do you thi
Page 120 and 121: 4.4.2 Before the woman became pregn
Page 124 and 125: 5.5 How many hours or days passed b
Page 126 and 127: 5.18 Would you say the baby’s siz
Page 128 and 129: 5.33 Did the baby ever move, even a
Page 130 and 131: SECTION 6. NEONATAL ILLNESS HISTORY
Page 132 and 133: 6.17 Did the baby have a swollen st
Page 134 and 135: SECTION 7. HISTORY OF INJURIES/ACCI
Page 136 and 137: 8.7 What were the reasons the baby
Page 138 and 139: 8.15.2 What difficulties did you ha
Page 140 and 141: SECTION 9. DATA ABSTRACTED FROM REC
Page 142: VA Supervisor comments and observat
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