Making Every Baby Count: Audit and Review of Stillbirths and Neonatal Deaths

A systematic analysis of mortality trends and contributing factors can help identify health system breakdowns and inform local solutions to prevent such deaths. The initiative is covered under two objectives of the Every Newborn Action Plan: to address quality of care at birth and to generate data for decision-making and action. Clear definitions and guidelines are essential for a functional death review process. The WHO Application of ICD-10 to Deaths during the Perinatal Period: ICD-PM provides a system for classifying perinatal cause of death, linking stillbirths and neonatal deaths to maternal contributory conditions. Making Every Baby Count uses a simplified version of ICD-PM for low-resource settings, with options to expand the classification in greater detail where feasible. The initiative focuses on three key aims: understanding the burden of stillbirths and neonatal deaths, generating information about causes of death and modifiable factors, and providing accountability for results. To achieve these aims, the initiative recommends setting up mortality audit at the facility level, establishing a review committee, mobilizing resources, deciding on an approach for review, and organizing data collection. The six-step cycle of auditing deaths at the facility level includes identifying cases for review, collecting information, analyzing information, recommending solutions, implementing solutions, and evaluating both process and outcomes. The initiative also emphasizes the importance of reporting audit findings, disseminating key messages to those who can implement the findings, and avoiding blame on patients, individual clinicians, or teams. Community involvement in mortality audit is crucial, particularly in capturing deaths that occur in the community. A verbal and social autopsy is a structured interview using a questionnaire administered to caregivers or family members of the deceased. This approach can help complete the picture of why deaths are occurring and how they can be prevented. The initiative provides a framework for implementing mortality audit and review of stillbirths and neonatal deaths. By following this framework, healthcare facilities and communities can identify areas for improvement, develop targeted interventions, and ultimately reduce the number of stillbirths and neonatal deaths. The initiative's focus on accountability, community involvement, and data-driven decision-making makes it a valuable tool for improving maternal and child health outcomes. Similarly, the Making Every Baby Count initiative can be implemented in various settings to reduce the burden of stillbirths and neonatal deaths. By establishing a review committee, mobilizing resources, and organizing data collection, healthcare facilities and communities can identify areas for improvement and develop targeted interventions. The initiative's focus on accountability, community involvement, and data-driven decision-making makes it a valuable tool for improving maternal and child health outcomes.