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Making Deaths Count: Using Perinatal Death Audits (PNDAs) to Increase Newborn Survival Overseas

Sk. Asiruddin, MBBS, MSc and La Rue K. Seims, MPH, MA. Save the Children, 2000 M Street, NW, Suite 500, Washington, DC 20036, 202 261 4697, lseims@dc.savechildren.org

Purpose of the Work to Be Presented:

To demonstrate the evidence for the effectiveness of PNDA in reducing perinatal deaths and how perinatal death audits (PNDA) were successfully introduced at the national level in Bangladesh.

Data or Information Used:

Data from several countries will be presented to demonstrate that perinatal death audit can be used effectively as a tool for improving maternal and neonatal outcome. The SNL experience in assisting the Government of Bangladesh to introduce death audits systematically and to develop supportive national policy will be presented.

Methods Used:

Results of a meta-analysis and advocacy.

Major Results:

Evidence will be presented to show that PNDAs can reduce deaths, including a meta-analysis of population-based studies of birth asphyxia and evidence from more than 100 health care facilities in South Africa. These data will demonstrate mortality decreases of up to 62% in stillbirths and up to 40% during the perinatal period. The data will further show that avoidable factors account for 10-76% of these deaths and that sub-standard care has been causally-linked to about half the cases. Important steps in setting up an audit system will be noted along with state-of-the-art tools, including software and distance education programs. Finally, SNL will explore its experience in assisting the Government of Bangladesh to set up a pilot PNDA system.

Recommendations or Policy Implications:

PNDAs are effective identifying primary and final causes with avoidable factors in reducing deaths during the critical perinatal period and should be introduced as a matter of government policy.

Learning Objectives: To learn

Keywords: Child Health, Child Health

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Save the Children/Saving Newborn Lives
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employed by Save the Children

Improving Health: What Works?

The 132nd Annual Meeting (November 6-10, 2004) of APHA