New national task force to conduct regular audits of perinatal deaths

04 March 2019
A health worker examining a newborn baby
UNICEF/2017

SKOPJE, 1 March 2019:  The newly established National Perinatal Mortality Audit Task Force commenced preparations for conducting regular systematic audits of all future perinatal deaths.  This is a new measure introduced by the Ministry of Health to improve mother and child health care through the systematic collection and analysis of data to inform evidence-based interventions.

Perinatal mortality –  fetal deaths (stillbirths) after 154 days of gestation and neonatal deaths in the first 28 days of life – is used to measure the quality of health care delivery. In North Macedonia, the latest available data (2016) shows a perinatal mortality rate of 16/1000 live births, which is above the EU member states average of 6/1000 live births, a situation that alarmed health professionals and the public and triggered accelerated efforts to improve the situation.

“Currently data on mortality does not include a comprehensive review of all the probable causes of death. This measure will ensure we systematically collect and analyze data on the root causes and that interventions to improve the health system and quality of care are evidence based,” said Dr. Venko Filipche, Minister of Health.

The task force will be using a standard methodology and training packages developed by World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) to conduct the systematic review of deaths. The package was introduced to the team yesterday during an introductory workshop supported by UNICEF. 

“There are great health professionals in the country - but doctors and nurses are only as good as the system they work in. Evidence based, internationally accredited protocols and guidelines that govern most European health systems not only need to be in place – professionals need the capacity to put them into practices,” said Mr. Benjamin Perks, UNICEF Representative.

The task force is made up of highly skilled professionals including gynecologists from both primary health care and maternity wards, neonatologists, pediatricians, epidemiologists, midwives, social workers and statisticians to ensure the audits consider all aspects of the possible cause of death – including those related to the health system and the mother’s health, social aspects and health seeking behaviors.  

During the preparatory phase of their work, using the standard methodology, the task force will conduct audits of recent past perinatal deaths. It is envisioned that audits of every single future death are conducted routinely and that the task force will issue special reports to the Ministry of Health with recommendations for both policy and health system strengthening changes.

Establishing the task force and introducing the systematic collection and analysis of data related to perinatal deaths is one of the measures adopted by the Ministry of Health to improve mother and child health care. Other measures include mapping of health institutions and their resources, development of standards for maternity wards, establishment of a system for regular maternal mortality audit, and establishment of newborn transportation system with appropriate standards. protocols and guidelines.

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