mapedir trainer slides session1.1 introduction_01_july07_pp95-2003
TRANSCRIPT
Increasing Awareness Increasing Awareness andand Empowering CommunitiesEmpowering Communities
Maternal and Perinatal Maternal and Perinatal Death Inquiry and ResponseDeath Inquiry and Response
MAPEDIRMAPEDIR
MAPEDIR’s purpose Increase awareness of maternal and
perinatal deathsMAPEDIR brings the deaths to light
Mobilizes communities to take local actionStimulates policy makers to improve health
services
MAPEDIR provides useful informationWhat caused local deathsSuggests ways to prevent similar deaths
MAPEDIR’s purpose Empower the community
Demystifies the causes of maternal and perinatal deaths and how to prevent them
Helps people understand they can take action to prevent deaths
Provides information to the community: To take effective local action To advocate for improved services
MAPEDIR’s purpose Inform the health system
Community death inquiries identify access issues and some quality of care problems Encourage community–health system
partnerships Facility-based death inquiries can
identify more quality of care problems
MAPEDIR’s context in India: The RCH II Program RCH II priorities (implemented by the
NRHM) Increase community (PRI, etc.) participation
in and demand for quality RCH services Evidence-based planning, resource allocation
and action to improve system quality and responsiveness
Strengthen the health system Institutional awareness, responsiveness and
accountability to improve RCH services
The MAPEDIR process
1a) Sensitize the communityPartner with NGOsMobilize the PRI, VHCs, SHGs, etc.Sensitize the community to maternal and
perinatal health issues: Birth preparedness / complication readiness Project purpose, and need to report maternal
deaths and conduct death inquiries Non-blaming, non-punitive approach
The MAPEDIR process
1b) Engage health officialsCreate a facilitating environment
Non-blaming, non-punitiveDevelop facility-based MAPEDIR
The MAPEDIR process
2) Identify maternal deathsBlock: expect 10-25 deaths / yearCurrently – most deaths not reported
Ways to increase death reportingSensitize the community to increase
awarenessKey informants (AWWs, TBAs, others)Health facility reports of deathsPregnancy registration and monitoring
The MAPEDIR process
3) Investigate the deaths (with verbal autopsy interviews)Biological causesSocial causes (careseeking delays and
reasons for the delays)
The MAPEDIR process
4) Analyze and interpret the dataQuantitative analysis – indicator levels
e.g., the percent of maternal deaths that did not seek any formal care
Qualitative analysis – the complete story of individual maternal deaths
Interpret – understand what are the most important causes and possible solutions
The MAPEDIR process
5) Share the data with the communityShare the analyses Interpret the data with the communityHelp the community:
Develop effective local interventions Advocate for improved services
The MAPEDIR process
6) Monitor interventionsContinue investigating maternal deaths
Are the interventions working? Are some women not being reached?
Modify the interventions as neededDevelop new interventions if needed