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  2. Vol 19, No 4 (2015)
  3. Demise

Prospective Audit of Avoidable Factors in Institutional Stillbirths and Early Neonatal Deaths at Tikur Anbessa Hospital in Addis Ababa, Ethiopia

Asrat Demise(1), Yirgu Gebrehiwot(2), Bogale Worku(3), Jonathan M Spector(4),


(1) Department of Pediatrics and Child Health, Addis Ababa University, School of Medicine, Addis Ababa, Ethiopia
(2) Department of Obstetrics and Gynecology, Addis Ababa University, School of Medicine, Addis Ababa, Ethiopia
(3) Ethiopian Pediatrics Society, Addis Ababa, Ethiopia
(4) Novartis Institutes for BioMedical Research, Cambridge Massachusetts USA
Corresponding Author

Abstract


Mortality audits are being used with increasing frequency to improve health outcomes by pinpointing precisely where deficiencies in clinical care exist. We conducted a prospective audit of stillbirths and early neonatal deaths at Tikur Anbessa Hospital in Addis Ababa, Ethiopia, as part of a broader initiative to reduce perinatal mortality in the labor room and neonatal intensive care unit. Out of 1,225 deliveries that took place during the six-month study period, there were 30 stillbirths and 31 early neonatal deaths (PMR 50/1,000). A multi-disciplinary Audit Team was established and convened monthly to review standardized data collection forms that were completed for each death. It was determined that avoidable factors were present in 70% of perinatal deaths. Health worker-related factors were the most common avoidable factors identified (accounting for 84% of avoidable factors identified), followed by patient-related factors (11%) and administrative-related factors (5%). Based on the study findings, quality improvement programs that target gaps in care are being implemented on the hospital‘s labor room and in the neonatal intensive care unit.

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