TABLE 2.

Examples of Successful Change Ideas Generated by Mentors and Mentees for Addressing System Failures That Lead to Maternal or Perinatal Deaths, Busoga Region, Uganda

CategoryIdeaWhere It Worked Well
SuppliesKeep a buffer stock of essential supplies that typically run out (e.g., blood products, medicines for managing pre-eclampsia and eclampsia, anticonvulsants for newborns, intravenous antibiotics, sterile gloves)All public facilities
Work with district health office leadership to access excess supplies, such as drugs, from less busy lower-level facilitiesAll public facilities
Clinical careEstablish a triage area and triage checklist to ensure all mothers are screened at admission to identify critical casesAll facilities (public and PNFP)
Use a predischarge checklist in the postnatal unit to ensure all mothers and babies who are discharged are stableAll facilities (public and PNFP)
Arrange the maternity unit so that unstable mothers requiring constant monitoring are close to nurse workstationsAll facilities (public and PNFP)
Ensure every mother is reviewed by a medical doctor or obstetrician before delivery1 public and 1 PNFP
Ensure 80% partograph use for all mothers in laborAll facilities (public and PNFP)
Assess blood pressure of all mothers at least twice before delivery (within 1 hour of birth and before discharge)All facilities (public and PNFP)
Ensure all mothers who enter the NCU wear a gown over their clothes to prevent infectionAt facilities with access to washing machine
Place hand sanitizer at all NCU entrances to prevent infectionAll facilities (public and PNFP)
AdministrativeEnsure representation of hospital administrator in maternity department meetings, including routine and non-routine (e.g., maternal and perinatal death review) meetingsAll facilities (public and PNFP)
Data-relatedEnsure all deliveries are entered in the maternity register and all NCU admissions in the newborn registerAll facilities (public and PNFP)
  • Abbreviations: NCU, newborn care unit; PNFP, private not-for-profit.