Hospital Maternal Mortality in Honduras: The Role of Providers and the Health System in Maternal Death
George Gilson, MD, and Anjou Parekh, MHS
In 1999, a maternal death review was conducted at two tertiary hospitals in Honduras: Hospital Mario Catarino Rivas (HMCR) and Hospital Escuela Francisco Morazan (HEFM). Thirty-five maternal deaths were reported over a 30 month period at HMCR (estimated hospital maternal mortality ratio is 207/100,000 live births); 81 maternal deaths were reported during a 33 month period at HEFM (estimated hospital maternal mortality ratio is 262/100,000 LB). It was determined that a large proportion of these deaths were preventable.
The death review looked at not only the causes of death, but also assessed facilities to examine provider skills and performance; policies, norms, and procedures; organization and management of services; physical facilities; accessibility and condition of appropriate drugs, supplies and equipment; and the quality of services provided. Quality of care issues were found to revolve around the following areas: clinical case management; laboratory, ultrasound and antenatal care services; epidemiologic surveillance; staffing patterns; infrastructure and equipment, and referral systems. Hospital errors or deficiencies were found in approximately 70% of deaths in both hospitals. Provider or health system errors were the primary attributable cause in 40% of cases in HMCR and 56% of cases in HEFM. Results of the death review, as well as recommendations for improved case management and program interventions, will be presented.
Learning Objectives: At the conclusion of the session, the participant in this session will be able to: -Identify the main causes of maternal mortality in two tertiary care facilities in Honduras -Describe interventions that can have an impact on hospital maternal mortality levels
Keywords: Health Assessment, Maternal Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.