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DHS-8-PGSSC-Maternal_Mortality-Template [message #16791]

Mon, 04 March 2019 17:04

PGSSC
Messages: 10
Registered: March 2019
Location: Boston, USA

Member

Thank you for reviewing our proposal for new indicators within the Demographic and Household Survey (DHS) regarding emergency and essential surgical care. The collection of these indicators is a critical step towards the delivery of safe, affordable, equitable access to surgical services as a component of universal health coverage and we consider the DHS as the best forum to derive these data points.

The questions we propose are a product of the Lancet Commission on Global Surgery (LCoGS), a body of work spanning three years involving 25 commissioners and a diverse group of academic, governmental and civil society collaborators from 110 countries. Of the six indicators proposed by the LCoGS, four were published in the World Development Indicators by the World Bank and all six are included in the World Health Organization's Global Reference List of 100 Core Health Indicators. Nevertheless, there currently are no mechanisms in place to collect the data required for these indicators, creating a critical gap in knowledge for surgical care strengthening.

The new indicators in this proposal span four existing DHS modules. For clarity, they are listed in the table below. Of particular interest are the questions on out-of-pocket expenditure and household expenditure to enable the calculation of financial risk protection for all medical interventions captured by the DHS (both surgical and medical), a core component of Sustainable Development Goal 3.8. The remaining questions were taken from a successful pilot DHS survey in Zambia. In the development of this application, we have been fortunate to count on a number of international partners to provide expert review and the indicators proposed are a culmination of these consensus building discussions. Please refer to Appendix A for a full list of international stakeholders who support this application.

Proposed Indicators:
1. Mortality following cesarean section

Data Utility:
1. WHO: 100 Core Health indicators

Attachment: DHS-8-PGSSC-Maternal_Mortality-Template.pdf
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Re: DHS-8-PGSSC-Maternal_Mortality-Template [message #16865 is a reply to message #16791]

Mon, 11 March 2019 13:15

JohnMeara
Messages: 10
Registered: March 2019
Location: Boston, MA, USA

Member

I agree and fully support this submission and would only suggest that Peri-operative mortality (POMR) be added. This metric has been accepted by the World Bank WDI group however, there is not presently enough data to publish so there must be an institutionalization of POMR data collection to track access to quality surgical, obstetric and anesthesia care globally. This was called for by the Lancet Commission on Global Surgery.

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Re: DHS-8-PGSSC-Maternal_Mortality-Template [message #16879 is a reply to message #16865]

Tue, 12 March 2019 18:52

PGSSC
Messages: 10
Registered: March 2019
Location: Boston, USA

Member

Dear Dr. Meara,

Thank you very much for your input.

There will be a new revised submission of the Maternal Mortality Module with POMR questions. It is also attached in this post form for your reference. Thank you very much for your feedback which is of crucial importance to support primary data collection in light of the World Bank Group WDI and the Lancet Commission for Global Surgery efforts baseline assessment and to track access to quality surgical, obstetric and anesthesia care globally.

The PGSSC

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Attachment: DHS-8-PGSSC-Maternal_Mortality_and_POMR-Excel.xlsx
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Re: DHS-8-PGSSC-Maternal_Mortality-Template [message #17375 is a reply to message #16791]

Fri, 15 March 2019 21:11

Girma
Messages: 3
Registered: March 2019

Member

Access to surgical and safe maternal care as a component of UHC is advanced and promoted by all WHO member states. It is absolutely critical that we measure in hospital mortality following child birth and any other surgery as a clear way of measuring quality of surgical and maternal care services. I applaud the sponsors for elevating quality measures that are easy to collect and meaningful in outcomes

Girma Tefera, MD
Medical Director Operation Giving Back- American College of Surgeons

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Re: DHS-8-PGSSC-Maternal_Mortality-Template [message #17383 is a reply to message #16791]

Fri, 15 March 2019 21:27

Robert Riviello
Messages: 7
Registered: March 2019

Member

C-section is the world's most common operation. Maternal mortality in LICs remains 10-20x higher than in HIC's. Let's start routinely measuring this, so we can track the impact of efforts to improve surgical care to protect mother's lives.

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