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Maternal morbidity measurement tool pilot: study protocol

机译：孕产妇发病率测量工具试点：研究方案

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Background While it is estimated that for every maternal death, 20–30 women suffer morbidity, these estimates are not based on standardized methods and measures. Lack of an agreed-upon definition, identification criteria, standardized assessment tools, and indicators has limited valid, routine, and comparable measurements of maternal morbidity. The World Health Organization (WHO) convened the Maternal Morbidity Working Group (MMWG) to develop standardized methods to improve estimates of maternal morbidity. To date, the MMWG has developed a definition and provided input into the development of a set of measurement tools. This protocol outlines the pilot test for measuring maternal morbidity in antenatal and postnatal clinical populations using these new tools. Methods In each setting, the tools will be piloted on approximately 250 women receiving antenatal care (ANC) (at least 28?weeks pregnant) and 250 women receiving postpartum care (PPC) (at least 6?weeks postpartum). The tools will be administered by trained health care workers. Each tool has three modules as follows: 1. personal history – socio-economic information, and risk-factors (such as violence and substance abuse) 2. patient symptoms – WHO Disability Assessment Schedule (WHODAS) 12-item, and mental health questionnaires, General Anxiety Disorder, 7-item (GAD-7) and Personal Health Questionnaire, 9-item (PHQ-9) 3. physical examination – signs, laboratory tests and results. Discussion This pilot (planned for Jamaica, Kenya and Malawi) will allow for comparing the types of morbidities women experience between and across settings, and determine the feasibility, acceptability and utility of using a modified, streamlined tool for routine measurement and summary estimates of morbidity to inform resource allocation and service provision. As part of the post-2015 Sustainable Development Goals (SDGs) estimating and measuring maternal morbidity will be essential to ensure appropriate resources are allocated to address its impact and improve well-being.
机译：背景虽然据估计每位孕产妇死亡中，有20-30名妇女发病，但这些估算并非基于标准化的方法和措施。缺乏商定的定义，识别标准，标准化的评估工具和指标，限制了对孕产妇发病率的有效，常规和可比较的测量。世界卫生组织（WHO）召集了孕产妇发病率工作组（MMWG），以开发标准化方法来改善对孕产妇发病率的估计。迄今为止，MMWG已经制定了定义，并为开发一套测量工具提供了投入。该协议概述了使用这些新工具测量产前和产后临床人群中母亲发病率的先导测试。方法在每种情况下，将对大约250名接受产前护理（ANC）的妇女（至少怀孕28周）和250名接受产后护理（PPC）的妇女（产后至少6周）进行试用。这些工具将由训练有素的医护人员进行管理。每个工具均具有以下三个模块：1.个人历史-社会经济信息和风险因素（例如暴力和滥用药物）2.患者症状-WHO残疾评估表（WHODAS）12个项目以及心理健康调查表，一般焦虑症7项（GAD-7）和个人健康问卷9项（PHQ-9）3.体格检查–体征，实验室检查和结果。讨论此试点（计划在牙买加，肯尼亚和马拉维进行）将允许比较妇女在不同地点之间以及不同地点所经历的发病类型，并确定使用经过改进的简化工具进行例行测量和发病率摘要估计的可行性，可接受性和实用性通知资源分配和服务提供。作为2015年后可持续发展目标（SDG）的一部分，估计和衡量孕产妇发病率对于确保分配适当的资源来解决其影响和改善福祉至关重要。

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