IVORY COASTIVORY COAST - Healthy Newborn Network · Partogram Protocol Antibiotics Eclampsia...
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Get involved: www.qualityofcarenetwork.org IVORY COAST IVORY COAST References: 1. Countdown to 2015, 2015 report See http://countdown2030.org/ 2. Maternal Death Surveilance and Response Country Profiles (WHO 2016). See http://www.who.int/maternal_child_adolescent/epidemiology/maternal-death-surveillance/country-profiles/ 3. Causes of Maternal Death: Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB,Daniels JD, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health 2014;2: e323-e333. 4. Causes of Newborn Death: UNICEF 2016 https://data.unicef.org/resources/maternal-newborn-health-disparities-country-profiles/ 5. Water, sanitation and hygiene in health care facilities, WHO and UNICEF (2016). See http://apps.who.int/iris/bitstream/10665/154588/1/9789241508476_eng.pdf?ua=1 6. All other data received from the relevant Ministry of Health and UNICEF and WHO Country Offices. Population Fertility rate per woman Total maternal deaths in 2015 Neonatal Mortality Rate Stillbirth rate Core demographic data 23 844 228 4.9 5 300 38 per 1,000 live births 26.7 per 1,000 births Demand for family planning satisfied 45 Antenatal care (4 or more visits) 44 Skilled attendance at delivery 59 C-section rate 3 Early initiation of breastfeeding 31 Exclusive breastfeeding 12 Postnatal visit for baby 34 Postnatal care for mother 70 Coverage of key interventions Costed National Implementation plan(s) for ma- ternal, newborn, child health available Maternal and Newborn Lifesaving Commodities on the national Essential Medicine list: Reproductive Health (x of 3) Maternal Health (x of 3) Newborn Health (x of 4) Child Health (x of 3) Density of Docters, Nurses and Midwives (per 10,000 population) National Availability of Emergency Obstetric Care Services (% of recommended minimum) Systems Yes - 2 3 3 6.3 7 Snapshot of readiness to improve quality of care Leadership Functional Leadership Structure for Quality Improvement Quality of Care Committees established in District Health Management Teams Plans, strategies & standards National Quality of Care Strategy for the Health Sector National Strategy for Maternal and Newborn Health addresses Quality of Care National Quality of Care Standards and Protocols Data National Situational Analysis for Quality of Care up to date Assessment of Quality of Care in Health Facilities completed in the past two years Supporting systems Maternal and Perinatal Death Surveillance and Response System established 13 Maternal and Newborn Lifesaving Commodities on the Essential Medicine list Water Coverage in Health Care Facilities (%) Skilled attendance at delivery (%) National Availability of EmOC (%) Achieved In process Not started No data 55% 59% 15% A Quality Improvement Coordination Committee is established. A Technical Coordination Work Group for Maternal and Newborn is represented on the Quality Improvement Coordination Committee. Governance of quality of care improvement Causes of death National Causes of Newborn Mortality (2015) Many partners are supporting quality improvement work including WHO, UNICEF, UNFPA, Muskoka, Man- agement Sciences for Health. Partnerships for quality of care improvement Global Causes of Maternal Mortality (2016) Indirect causes 27% Abortion 8% Embolism 3% Haemorrhage 27% Hypertension 14% Sepsis 11% Other direct causes 10% Policies Midwives authorised for specific tasks (x of seven) Maternal deaths notification Postnatal home visits in first week after birth Kangaroo mother care in facilities for low birth- weight/preterm newborns Antenatal corticosteroids as part of the manage- ment of preterm labour International Code of Marketing of Breastmilk Substitutes 7 of 7 Yes Yes Yes Yes Yes Infrastructures Triage / flow of patients Water, electricity Operating room Intensive care unit Laboratory Referral Human resources Number / type Nights and week ends Training Case management Hand washing Partogram Protocol Antibiotics Eclampsia Prolapsed cord Shoulder dystocia Caesarean section Equipment/drugs Laboratory proteinuria Haemoglobin, haematocrit Urine microscopy Blood grouping, count, glucose Bacteriology (culture) Drugs anti-hypertensive anticonvulsants magnesium sulphate corticosteroids diuretic oxytocin tocolytic antibacterial IV catheters Blood products blood Equipment sphygmomanometers thermometers gloves Urine dipsticks oxygen incubator Caesarean kit Anaesthesia kit Postpartum haemorrhage kit Medical information Medical record Finance Free health care Summary Maternal case management Treichville Hospital Labour delivery Dystocia Postpartum haemorrhage Eclampsia Caesarean section Infection Preterm labour Standards Neonatal and Child Health Standards are currently being finalised. Available Standards and Protocols • National guidelines on minimum package of health activities at district hospital level (2006) • National guidelines on minimum package of health activities at first contact level facilities. • National compilation of treatment protocols Only 35% of mothers in the poorest households had a skilled attendant at birth, compared to 91% of mothers in the richest households. Disparity of the coverage of maternal and newborn care 35% 91% Poorest Richest The National Health Sector Development Plan (2016-2020) emphasises the delivery of quality service. In June 2016, the National Policy on Quality Improvement for Health Services in Cote D’Ivoire was launched. National quality of care strategies and plans Table 1: Evaluation of labour and delivery management, based on clinical conditions at Treichville Hospital (2015) Health Facility Assessment In 2015, an assessment of the quality of care and service for maternal, newborn and child health was undertaken in five hospitals. See Table 1 for the results for Treichville Hospital, the largest Teaching Hospital in the country. % conforming good non applicable non-conforming considerable improvements to be improved some improvements Congenital abnormalities 6% Tetanus, 1% Pneumonia, 6% Diarrhoea, 1% Other conditions, 6% Sepsis/ meningitis 20% Preterm birth complications 32% Intrapartum- related events 27%
Transcript of IVORY COASTIVORY COAST - Healthy Newborn Network · Partogram Protocol Antibiotics Eclampsia...
Get involved: www.qualityofcarenetwork.org
IVORY COASTIVORY COAST
References:1. Countdown to 2015, 2015 report See http://countdown2030.org/
2. Maternal Death Surveilance and Response Country Profiles (WHO 2016). See
http://www.who.int/maternal_child_adolescent/epidemiology/maternal-death-surveillance/country-profiles/
3. Causes of Maternal Death: Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB,Daniels JD, et al. Global causes of maternal
death: a WHO systematic analysis. Lancet Glob Health 2014;2: e323-e333.
4. Causes of Newborn Death: UNICEF 2016
https://data.unicef.org/resources/maternal-newborn-health-disparities-country-profiles/
5. Water, sanitation and hygiene in health care facilities, WHO and UNICEF (2016). See
http://apps.who.int/iris/bitstream/10665/154588/1/9789241508476_eng.pdf?ua=1
6. All other data received from the relevant Ministry of Health and UNICEF and WHO Country Offices.
PopulationFertility rate per womanTotal maternal deaths in 2015Neonatal Mortality RateStillbirth rate
Core demographic data
23 844 2284.95 30038 per 1,000 live births26.7 per 1,000 births
Demand for family planning satisfied 45Antenatal care (4 or more visits) 44Skilled attendance at delivery 59C-section rate 3Early initiation of breastfeeding 31Exclusive breastfeeding 12Postnatal visit for baby 34Postnatal care for mother 70
Coverage of key interventions
Costed National Implementation plan(s) for ma-ternal, newborn, child health availableMaternal and Newborn Lifesaving Commodities on the national Essential Medicine list:Reproductive Health (x of 3)Maternal Health (x of 3)Newborn Health (x of 4)Child Health (x of 3)Density of Docters, Nurses and Midwives (per 10,000 population)National Availability of Emergency Obstetric Care Services (% of recommended minimum)
Systems
Yes
-233
6.3
7
Snapshot of readiness to improve quality of care
Leadership Functional Leadership Structure for Quality Improvement Quality of Care Committees established in District Health Management TeamsPlans, strategies & standardsNational Quality of Care Strategy for the Health SectorNational Strategy for Maternal and Newborn Health addresses Quality of CareNational Quality of Care Standards and Protocols DataNational Situational Analysis for Quality of Care up to dateAssessment of Quality of Care in Health Facilities completed in the past two yearsSupporting systems Maternal and Perinatal Death Surveillance and Response System established 13 Maternal and Newborn Lifesaving Commodities on the Essential Medicine listWater Coverage in Health Care Facilities (%)Skilled attendance at delivery (%)National Availability of EmOC (%)
Achieved In process Not started No data
55%59%15%
A Quality Improvement Coordination Committee is established. A Technical Coordination Work Group for Maternal and Newborn is represented on the Quality Improvement Coordination Committee.
Governance of quality of care improvement
Causes of death
National Causes of Newborn Mortality (2015)
Many partners are supporting quality improvement work including WHO, UNICEF, UNFPA, Muskoka, Man-agement Sciences for Health.
Partnerships for quality of care improvement
Global Causes of Maternal Mortality (2016)
Indirect causes27%
Abortion8%
Embolism3%
Haemorrhage27%
Hypertension14%
Sepsis11%
Other direct causes10%
Policies
Midwives authorised for specific tasks (x of seven)Maternal deaths notificationPostnatal home visits in first week after birthKangaroo mother care in facilities for low birth-weight/preterm newbornsAntenatal corticosteroids as part of the manage-ment of preterm labourInternational Code of Marketing of Breastmilk Substitutes
7 of 7YesYesYes
Yes
Yes
InfrastructuresTriage / flow of patientsWater, electricityOperating roomIntensive care unitLaboratoryReferralHuman resourcesNumber / typeNights and week endsTrainingCase managementHand washingPartogramProtocol AntibioticsEclampsiaProlapsed cordShoulder dystociaCaesarean sectionEquipment/drugsLaboratory proteinuriaHaemoglobin, haematocritUrine microscopyBlood grouping, count, glucoseBacteriology (culture)Drugsanti-hypertensiveanticonvulsantsmagnesium sulphate corticosteroidsdiureticoxytocintocolyticantibacterialIV cathetersBlood productsbloodEquipmentsphygmomanometersthermometersglovesUrine dipsticksoxygenincubatorCaesarean kit Anaesthesia kit Postpartum haemorrhage kitMedical information Medical recordFinanceFree health careSummaryMaternal case management
Treichville HospitalLabour
delivery Dystocia Postpartum
haemorrhageEclampsia Caesarean
sectionInfection Preterm
labour
Standards
Neonatal and Child Health Standards are currently being finalised.Available Standards and Protocols • National guidelines on minimum package of health
activities at district hospital level (2006)• National guidelines on minimum package of health
activities at first contact level facilities.• National compilation of treatment protocols
Only 35% of mothers in the poorest households had a skilled attendant at birth, compared to 91% of mothers in the richest households.
Disparity of the coverage of maternal and newborn care
35% 91%Poorest Richest
The National Health SectorDevelopment Plan (2016-2020)emphasises the delivery ofquality service.
In June 2016, the NationalPolicy on Quality Improvementfor Health Services in CoteD’Ivoire was launched.
National quality of care strategies and plans
Table 1: Evaluation of labour and delivery management, based on clinical conditions at Treichville Hospital (2015)
Health Facility Assessment
In 2015, an assessment of the quality of care and service for maternal, newborn and child health was undertaken in five hospitals. See Table 1 for the results for Treichville Hospital, the largest Teaching Hospital in the country.
%
conforminggood
non applicablenon-conforming
considerableimprovements
to be improvedsome improvements
Congenital abnormalities6%
Tetanus, 1%
Pneumonia, 6%
Diarrhoea, 1%
Other conditions, 6%
Sepsis/meningitis20%
Preterm birthcomplications32%
Intrapartum-related events27%
