Making Every Baby Count

6.2 Collating data and linking to existing information
infrastructure
A data flow algorithm may be useful for assigning responsibility to named people along
the path of data collection (see Figure 6.2). This brings the vital step of accountability into
the process. Different individuals may be involved depending on the size of the facility, the
capacity for electronic data collection and the level of integration with existing information
systems. The staff responsible for each stage could be physicians, midwives or data clerks,
but there should be clearly designated individuals trained on the system, with the mortality
audit coordinator or steering committee overseeing the process, including integration with
CRVS and the HMIS.
Reports emerging from single-facility mortality audit committees can be collated and linked
to other outputs. A multi-facility review report may have broader audiences: all the facilities
involved in the review, other facilities in the area (public and private), various decision-makers,
insurance companies and teaching institutions, as well as national authorities and the
public. A national confidential enquiry will produce a comprehensive report that is widely
distributed to all its stakeholders, including being available to the public. The frequency of
publication of these reports will depend on the number of cases reviewed and the willingness
of stakeholders to write, edit and publish findings. However, remedial action does not
need to wait for the report to be published. Sometimes the findings of a single case review
can reveal a significant problem that needs to be addressed immediately. The frequency
and importance of other problems may only become apparent after the information from
the qualitative review is quantitatively analysed.
The ENAP Measurement Improvement Roadmap (2015–2020) has outlined tools to be
developed and has created an opportunity to embed improved newborn data and tools
into national health systems through World Health Assembly (WHA) commitments to
improve the use of key newborn data in countries (18). Progress in meeting milestones
is reviewed annually at the WHA – the establishment of this annual reporting obligation
has supported a transparent accountability mechanism with a specific focus on the use of
newborn data. Mortality audit, in addition to improved birth and death registration, promoting
a minimum set of perinatal indicators to be collected, and actions to test, validate
and institutionalize proposed coverage indicators, is a key component of this improvement
agenda. The roadmap presents a unique opportunity to strengthen routine HMISs, linking
these data with CRVS and population-based surveys (9).
MAKING EVERY BABY COUNT: AUDIT AND REVIEW OF STILLBIRTHS AND NEONATAL DEATHS
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