MPDR e-Newsletter

Centre for Injury Prevention and Research, Bangladesh (CIPRB)

Inside this issue

MPDR Data Integration …………….……2

MPDR shared at HMIS workshop ……3

A Verbal Autopsy Case Study ………… 3

Technical Workshop ……………………....4

Findings of Review Meetings……..…….5

MPDR in quality of facility care………..5

Utilization of MPDR data in Thakurgaon …………………………………….5

Special points of interest

Civil Surgeon of Bagerhat dis-

cussed on MPDR intervention.

Sadar Upazila, Panchagarh

organized a social awareness

meeting and health camp.

Superstitions and unawareness

still persists in the society:

Revealed from a Social Autopsy

Debiganj Upazila, Panchagarh has taken initiatives to improve MNH services utilizing MPDR findings. The Civil Surgeon & Deputy Director, Family Planning of Panchagarh joint-ly organized a coordination meeting with the Upazila Chairman, Union Chairmen, Government officials, health and family planning staffs of De-biganj Upazila on 20 August 2014 at Upazila Parishad Auditorium, Debiganj, Panchagarh.

MPDR findings was presented showing high maternal deaths in the upazila during last nine months, of which five maternal deaths occurred in one union named Sonahar. The meeting recognized MPDR as a very important program that gave a real picture of maternal mortality of their upazila for the first time. The Upazila Chairman of Debiganj mentioned, “ I never thought of this situation that we are loosing so many mothers’ lives. I strongly urge to work together to aware people on maternal and neonatal complications so that they can take early and proper care”.

The Civil Surgeon said, “ The health system is now notifying each of ma-ternal and neonatal deaths though MPDR Intervention and the findings is now in use for improvement of health services”. The Chief guest, Addi-tional District Magistrate of Panchagarh said that coordination between health and family planning department & local government will be effec-tive to reduce maternal and newborn deaths in coming future.

August 2014 Issue : 2

Maternal & Perinatal Death Review (MPDR) Intervention is under implementation in 10 Districts of Bangladesh by

CIPRB– UNICEF partnership under the guidance of the Line Director, MNCAH of DGHS in collaboration with the Line

Director , MCRAH of DGFP within scope of Joint GoB-UN Maternal & Newborn Health Initiatives

Photo : The Civil Surgeon, Panchagarh delivering speech in

Debiganj Initiative on 20 August , 2014.

The UH&FPO, Purbadhala

mentioned -

“MPDR maternal and

newborn death data can

easily be incorporated in

MIS. Deaths information

are jointly collected by

the HA and FWA at the

filed, there are no over-

lapped information. So,

it’s the representative

data of the Upazila”.

Health and Family Planning Departments discussed about the integration of

MPDR data into the MIS, DGHS. Purbadhala Upazila was firstly chosen to

discuss how to integrate the data with the Upazila Health and Family

Planning Managers. Both Managers of Health and Family Planning Depart-

ments agreed to use the database of DHIS-2. In a second meeting held at

district level, the Civil Surgeon and DDFP both agreed to collaborate. The

decisions included to initial start with entering maternal deaths in Purbadha-

la and explore challenges so that all data can be incorporated.

“ I have received a formal training from MIS, DGHS on how to enter data in DHIS-2. Now I can easily enter the MPDR maternal and neonatal death data into the system “ - Statistician of Purbadhala Upazila said.

Integration of MPDR data into the Health Information System (MIS), DGHS : An unique initiative

MPDR data integration into DHIS-2 data base of MIS, DGHS : Netrokona

2

In August, Upazila Health Managers of Purbadhala

Upazila, Netrokona initiated integration of maternal

and neonatal death information from MPDR Inter-

vention into DHIS-2, the database software of MIS,

DGHS. The Upazila Statistician has done a successful

entry of MPDR notified death data of 2014 into DHIS-

2.

Mr. Rezwan, HMIS consultant of UNICEF assisted the

Statistician for initial data entry. Dr Mridul and Mr. Abu

Sayeed from CIPRB also took part in the process.

This effort is a milestone for MPDR Intervention by

integrating 06 maternal deaths from Purbadhala into

the DHIS-2 database of MIS, DGHS for the first time. Photo : HMIS consultant, UNICEF supporting the Statistician

to incorporate MPDR maternal death data into DHIS-2

Photo : MPDR data integration meeting at Purbadhala Upazila

Verbal Autopsy of a maternal death moni-tored by the UH&FPO, Rajnagar Upazila, Moulvibazar

On 16th August, 2014 - A

Verbal Autopsy of a maternal

death has been monitored by

Dr. Partha Sarathi, UH&FPO

of Rajnagar Upazila,

Moulvibazar District. Dr Partha

visited deceased house with filed

level health staff. The HI

working in the Nondiura

Village conducted the Verbal

Autopsy (VA). The UH&FPO identified that

the mother was at high risk ( 40

years aged) , she delivered a

baby and died due to Post

Partum Haemorrhage (PPH)

and Eclampsia.

The UHFPO focused to health

staff to raise more awareness and

promote for facility delivery. He

also mentioned quality antenatal

care will be strengthen in places

where more maternal and neona-

tal deaths occurred in this Upazila.

MPDR findings shared in HMIS review workshops of DGHS in Hard to Reach Districts, Bangladesh

In August , HMIS of DGHS organized workshops at the hard to reach

Districts of UNICEF ( Cox’s Bazar, Netrokona and Bandarban ) with the

support of UNICEF, Bangladesh. As a part of strengthening the health

system by integrating maternal and newborn death information, MPDR

findings have presented in the meetings. The District and Upazila Health &

Family Planning Managers participated in those workshops.

MPDR data has shown that maternal and neonatal deaths are now

reporting utilizing government system and Managers are well informed

where the deaths are higher.

Representative from MIS, Dr Shah Ali Akbar Ashrafi mentioned in one of

the meeting “ MPDR data is useful for understanding maternal and new-

born health situation in the District. It can also support the Health

Managers for planning and implementation of need based program”.

Dr Animesh Biswas, Team Leader of MPDR, CIPRB informed in one of the

meetings that the MPDR data has been providing scope to identify areas

with more occurrence of maternal & neonatal deaths; especially a scope

to such status in hard to reach areas of the Districts. Based on the data,

the health and family planning managers could prepare and implement

specific remedial actions in specific vulnerable areas.

3

Photo : MPDR presentation in HMIS Review Workshop at Cox’s Bazar ,19 August

2014

Photo : UHFPO, Rajnagar Upazila

of Moulvibazar District is observing a

Verbal Autopsy of a maternal death.

“ From the MPDR find-

ings, we have noticed

that highest maternal

deaths are occurring in

Sarankhola Upazila, is

one of the very hard to

reach areas in the

District. My department

will take initiatives for

Sarankhola to address

the mother and newborn.

We are also planning to

look at the quality ante-

natal care in the district “

– The Civil Surgeon of

Bagerhat mentioned.

Civil Surgeon of Bagerhat discussed on MPDR Intervention

On 5th and 6th August, 2014, CIPRB participated in a technical workshop on NGOs’ reporting and M&E held at

MIS Conference Room of DGHS organized by the maternal and neonatal health programme of DGHS. The

meeting discussed on different aspects of coordination among partner NGOs working on maternal and new-

born health and monitoring and evaluation of their projects.

During the two days workshop, Dr. Mridul Kanti Ghosh, Deputy Team Leader and Abu Sayeed Md. Abdullah ,

Field Research Officer took part in the workshop as part of CIPRB’s commitment to integration of MPDR data.

On 28th August, Dr.

Bakir Hossain, the Civil

Surgeon of Bagerhat

shared his experiences

during implementing

MPDR in the District.

Dr. Bakir mentioned

that Bagerhat is a large

District in Bangladesh

with a number of hard to reach

areas. Especially, it includes part

of the largest Mangrove forest-

Sundarban. Because of its geo-

graphic nature, reporting of

maternal and neonatal deaths

was poor previously while

currently introduced MPDR

system has been successfully

reporting those deaths to health

system. He stressed on utilization

of MPDR data for improvement of

MNH services in the district.

4

Superstitions and Unawareness still persists in the society: Revealed from A Social Autopsy

Technical workshop on Reporting and M&E of Partner NGOs

CIPRB expressed its strong commitment for integrating MPDR data into HMIS:

On 5th August , 2014 Social Autopsy (SA) of a mater-

nal death observed by Prof. M A Halim, Director, RCH

Unit of CIPRB in Monir Para, Sonaher Union, Debiganj

Upazila, and Panchagarh. Dr. Iqbal Anwar, Scientist,

ICDDR,B was also present there.

The SA was conducted by FPI of the union and

explored that the family had myth that the mother

was caught by ghost . However, the mother died due

to eclampsia after delivery.

Photo : Civil Surgeon, Bagerhat discussing on MPDR

Photo : Prof. MA Halim discussing with the community in

a Social Autopsy

“ MPDR data already been used for a number of initiatives in Thakurgaon including health camp, improvement of services in the Community Clinics, and raising awareness through Social Autop-sies. New initiative in Sengaon will definitely come up with new information” - CS, Thakurgaon mentioned.

An initiative was undertaken to explore the

best utilization of MPDR data and its find-

ings. Thakurgaon District was chosen for

initial trial. Two meetings were organized:

one in Pirganj Upazila and another at the

District level. These meetings proposed to

explore the ways for best utilization of

MPDR findings. These meetings agreed to

utilize community clinics for coverage and

early death notification using CC’s network-

ing: CG and committees. The community

clinic can help conduct social autopsies on

maternal and neonatal deaths to build com-

munity awareness.

These meetings emphasized on coordination and monitoring of activities based on MPDR data to see

progress in MNH services.

Upazila and District MPDR Review Meetings discussed on MPDR findings of 2014. In Thakurgaon, Panchagarh, Netrokona, Cox’s Bazar, Narail & Bagerhat Districts, data has been shared with the Upazila

and District Health & Family Planning Man-gers. In August, 38 Upazila MPDR Review Meetings and Six District meetings were organized.

5

MPDR data and its analytic findings proved to be useful in monitoring and improving health system responses: the Civil Surgeon said

MPDR data used to improve quality of maternal-newborn care in District Hospital

Photo: Facility Death Review Meeting at Netrokona

Photo: Meeting at CS conference room, Thakurgaon : Best utilization of MPDR

Photo : The Vice Principal delivering speech in

District Review Meeting, Cox’s Bazar on 20

August 2014.

Findings has been shared in a District MPDR review meeting in Coxs’Bazar: August 2014

In August, 2014, Cox’s Bazar,

Netrokona, Narail and

Bagerhat Districts organized

Facility Death Review

Meetings at the District

Hospitals. The aim of those

meetings were to share and

discuss on Facility Death

Review findings from MPDR.

The Consultants and District

Health Mangers explored a

number of challenges and

some initiatives were taken

at the facility, based on the

MPDR data for improve-

ment of facility care.

Hafizabad Union

of Sadar Upazila in

Panchagarh was

identified as an

area with high

maternal deaths.

Six maternal

deaths were re-

ported though

MPDR in 08

months. The Civil

Surgeon and DDFP

of Panchagarh

took joint initiative to organize a health camp of pregnant mother with a

social awareness programme in Sarderpara Village of that Union. The

meeting was organized in presence of UH&FPO and UFPO of Sadar Upazila

and Dr Sanchoy Kumar Chanda , Senior Technical Officer of UNFPA.

DDFP mentioned “I was born in Panchagarh & spent many years here. I

feel proud about MPDR Intervention as an effective program to identify

vulnerable areas to take special initiatives to address the challenges” .

Dr Sanchoy of UNFPA participated in dialogue with the community in the

awareness meeting and showed the joint UN commitment to work in ma-

ternal and newborn initiatives.

Sadar Upazila, Panchagarh organized a social awareness meeting and health camp

Contact :

Centre for Injury Prevention &

Research, Bangladesh (CIPRB)

House B162, Road 23, New DOHS,

Mohakhali, Dhaka

E mail: info@ciprb.org

web: www.ciprb.org

Phone: +880-2-8814988

Editorial Board:

Editors : Prof. M. A. Halim, Director , RCH Unit

Dr Animesh Biswas, Senior Scientist , RCH unit

Co– Editors : Dr Mridul Kanti Ghosh, Deputy Team Leader

Abu Sayeed Md. Abdullah, Field Research Officer

Published from : Reproductive and Child Health Unit, CIPRB

A short note on MPDR

MPDR was adopted from the

“Beyond the Number”—death sur-

veillance cycle developed by the

World Health Organization in 2004.

Bangladesh has initiated MPDR in

2010. The MPDR has focused from its

piloting on utilization of data to pre-

pare and implement remedial re-

sponse at the local level for the im-

provement of MNH services which is

aligned with recently developed Ma-

ternal Death Surveillance and Re-

sponse (MDSR) of WHO in 2012.

The intervention has set a good ex-

ample of coordination and collabora-

tion between DGHS, DGFP and GoB

partners and data has been utilized in

local planning for improvement of

MNH services in Thakurgaon. Follow-

ing this, the intervention expanded in

other 3 MNHI districts- Jamalpur,

Narail, and Moulvibazar from January

2011 to December 2012. Looking at

the best utilization of MPDR findings

in planning, monitoring and make

MPDR sustain in Bangladesh context ,

the intervention further expand in

another six districts from October

2013 till date.

Photo: CS, Panchagarh delivering speech in the health camp