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dc.contributor.author | Kinney, Mary![]() |
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dc.contributor.author | George, Asha S.![]() |
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dc.contributor.author | Rhoda, Natasha R.![]() |
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dc.contributor.author | Pattinson, Robert Clive![]() |
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dc.contributor.author | Bergh, Anne-Marie![]() |
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dc.date.accessioned | 2024-07-02T10:44:47Z | |
dc.date.available | 2024-07-02T10:44:47Z | |
dc.date.issued | 2023-04 | |
dc.description | DATA AVAILABILITY STATEMENTS : All data relevant to the study are included in the article or uploaded as supplemental information. Patient identifiable data not applicable. | en_US |
dc.description.abstract | INTRODUCTION : Maternal and perinatal death surveillance and response (MPDSR), or related forms of maternal and perinatal death audits, can strengthen health systems. We explore the history of initiating, scaling up, and institutionalizing a national perinatal audit program in South Africa. METHODS : Data collection involved 56 individual interviews, a systematic document review, administration of a semistructured questionnaire, and 10 nonparticipant observations of meetings related to the perinatal audit program. Fieldwork and data collection in the subdistricts occurred from September 2019 to March 2020. Data analysis included thematic content analysis and application of a tool to measure subdistrict-level implementation. This study expands on case study research applied to 5 Western Cape subdistricts with long histories of implementation. RESULTS : Although established in the early 1990s, the perinatal audit program was not integrated into national policy and guidelines until 2012 but was then excluded from policy in 2021. A network of national and subnational structures that benefited from a continuity of actors evolved and interacted to support uptake and implementation. Intentional efforts to demonstrate impact and enable local adaptation allowed for more ownership and buy-in. Implementation requires continuous efforts. Even in 5 subdistricts with long histories of practice, we found operational gaps, such as incomplete meeting minutes, signaling a need for strengthening. Nevertheless, the tool used to measure implementation may require revisions, particularly in settings with institutionalized practice. CONCLUSION : This article provides lessons on how to initiate, expand, and strengthen perinatal audit. Despite a long history of implementation, the perinatal audit program in South Africa cannot be assumed to be indefinitely sustainable or final in its current form. To monitor uptake and sustainability of MPDSR, including perinatal audit, we need research approaches that allow exploration of context, local adaptation, and underlying issues that support sustainability, such as relationships, leadership, and trust. | en_US |
dc.description.department | Obstetrics and Gynaecology | en_US |
dc.description.sdg | SDG-03:Good heatlh and well-being | en_US |
dc.description.sponsorship | The South African Research Chair’s Initiative of the Department of Science and Technology, National Research Foundation of South Africa, the South African Medical Research Council, and the Countdown 2030 project funded by the Bill & Melinda Gates Foundation. | en_US |
dc.description.uri | http://www.ghspjournal.org | en_US |
dc.identifier.citation | Kinney, M.V., George, A.S., Rhoda, N.R., Pattinson, R.C. & Bergh, A.-M. From pre-implementation to institutionalization: lessons from sustaining a perinatal audit program in South Africa. Global Health: Science and Practice 2023; 11(2): e2200213. https://DOI.org/10.9745/GHSP-D-22-00213. | en_US |
dc.identifier.issn | 2169-575X (online) | |
dc.identifier.other | 10.9745/GHSP-D-22-00213 | |
dc.identifier.uri | http://hdl.handle.net/2263/96760 | |
dc.language.iso | en | en_US |
dc.publisher | Johns Hopkins University Press | en_US |
dc.rights | © Kinney et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0). | en_US |
dc.subject | Maternal and perinatal death surveillance and response (MPDSR) | en_US |
dc.subject | Maternal and perinatal death audits | en_US |
dc.subject | Perinatal audit program | en_US |
dc.subject | South Africa (SA) | en_US |
dc.subject | SDG-03: Good health and well-being | en_US |
dc.title | From pre-implementation to institutionalization : lessons From sustaining a perinatal audit program in South Africa | en_US |
dc.type | Article | en_US |