A study on maternal mortality in Mozambique detects a major diagnostic error in a high percentage of deaths

July 14, 2020

Barcelona, July 14, 2020-. An analysis of a series of maternal deaths in Maputo's central hospital, in Mozambique, reveals a major diagnostic error in almost 40% of the deaths. The results, published in Lancet Global Health, show there has been scarce improvement over the last ten years. The study was led by the Barcelona Institute for Global Health (ISGlobal), an institution supported by the "la Caixa" Foundation, in collaboration with Manhiça Health Research Centre (CISM) in Mozambique.

Although the number of women in low- and middle-income countries that give birth in health centres has increased over the last years, maternal mortality remains extremely high in these countries: more than 300,000 women die during pregnancy, delivery or puerperium every year worldwide, and 99% of these deaths occur in poor countries.

"It is not only about increasing access to health services, but also increasing the quality of the care provided," says Clara Menéndez, director of the Maternal, Child and Reproductive Health Initiative at ISGlobal and first author of the study. "A key - and often neglected- element for improving healthcare quality is the correct diagnosis of diseases that can lead to death in pregnant women," she adds.

In this study, the team led by Jaume Ordi, ISGlobal researcher and pathologist at the Hospital Clinic, retrospectively analysed a series of deaths that occurred in Maputo's central hospital, in southern Mozambique, between November 2013 and March 2015. They compared the clinical diagnosis with diagnosis by complete autopsy and they observed that in almost 40% of the deaths there was a major diagnostic error where, if a correct diagnosis had been made, death could possibly have been avoided.

"If we compare these results with a similar study done ten years earlier, we can see that the diagnostic capacity has barely improved and has even worsened for some pathologies such as puerperal infections," says Ordi.

These results highlight the need to improve diagnostic capacities through the access to better diagnostic tests and strengthening clinical skills among the healthcare workers. "The practice of autopsies and the joint analysis of the diagnostic discrepancies with clinicians and pathologists could be of great help for the medical staff providing care for pregnant women," concludes Menéndez.

Menéndez C, Quintó Ll, Castillo P, et al. Quality of care and maternal mortality in a tertiary-level hospital in Mozambique: a retrospective study of clinicopathological discrepancies. July, 2020 DOI: https://doi.org/10.1016/S2214-109X(20)30236-9

About ISGlobal

The Barcelona Institute for Global Health, ISGlobal, is the fruit of an innovative alliance between the "la Caixa" Foundation and academic and government institutions to contribute to the efforts undertaken by the international community to address the challenges in global health. ISGlobal is a consolidated hub of excellence in research that has grown out of work first started in the world of health care by the Hospital Clínic and the Parc de Salut MAR and in the academic sphere by the University of Barcelona and Pompeu Fabra University. The pivotal mechanism of its work model is the transfer of knowledge generated by scientific research to practice, a task undertaken by the institute's Education and Policy and Global Development departments. ISGlobal has been named a Severo Ochoa Centre of Excellence and is a member of the CERCA programme of the Generalitat de Catalunya.

Barcelona Institute for Global Health (ISGlobal)

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