International Federation of Gynecology and Obstetrics

Ethiopian Society of Obstetricians and Gynaecologists (ESOG)

ESOG was established in 1992 and currently has about 247 members. ESOG is working to promote and improve sexual and reproductive health as well as ensuring professional standards in Obstetrics and Gynaecology in Ethiopia.  

Maternal Death and Near Miss Reviews

ESOG in collaboration with FIGO LOGIC and Federal Ministry of Health of Ethiopia introduced facility-based Maternal Death Reviews (MDRs) and Near Miss Reviews (NMRs) in a number of hospitals and satellite health centres in 2011. ESOG is currently supporting the implementation of MDRs/NMRs in nine public hospitals and 45 health centres  in four regions of Ethiopia (i.e. Addis Ababa, Amhara, Oromia and SNNPR) – thereby reviewing  the causes and circumstances surrounding maternal deaths, and so called near misses when women survive obstetric complications.  

ESOG has successfully been working with the public health facilities to ensure staff ownership of the process. The fact that hospital staff have not been reluctant to report maternal deaths or near misses, nor have they feared punitive action is credit to the successful management of the introduction of MDRs/NMRs by ESOG. ESOG has found that the MDRs/NMRs provide a good learning experience for staff if the reviews are done in a participatory manner. 

ESOG conducted primary analysis of facility-based MDR/NMR data between May and October 2011 from eight public hospitals to find out the causes and circumstances surrounding maternal mortality and morbidity. During this period there were 119 maternal deaths and 989 near miss cases out of a total of 9712 women giving birth. Hence, 1.2% of the total facility-based deliveries resulted in maternal deaths in the participating health facilities  

The leading causes of maternal deaths and near misses were; preeclampsia/eclampsia (29%); obstetric hemorrhage (16%); and uterine rupture (13%). Nearly 53% of deliveries were attended at home and phase I delay (delay in decision to seek care) contributed to about 25% of maternal deaths and near misses in the health facilities. 

The MDRs/NMRs have resulted in change in clinical practice within the health facilities. For example, as a result of the MDR/NMR process, the hospital at Debre Berhan has reported many improvements, including increased use of the partogram from 48 per cent to 85 per cent; increased and appropriate administration of magnesium sulphate; better adherence to protocols; and increased availability of drugs.  

For further information about ESOG, please visit www.esog.org.et