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Hospitals take steps to reduce maternal, child mortality rates

Maternal and child mortality rates could be reduced in Vietnam if hospitals actively seek solutions to prevent medically adverse events and medical errors, the Maternal and Child Health Department of the Ministry of Health has recommended.
Hospitals take steps to reduce maternal, child mortality rates ảnh 1A newborn is treated at the Da Nang Hospital for Women and Children in Da Nang City. (Photo: VNA)
HCM City (VNS/VNA) - Maternaland child mortality rates could be reduced in Vietnam if hospitals activelyseek solutions to prevent medically adverse events and medical errors, theMaternal and Child Health Department of the Ministry of Health has recommended.

When a medically adverse event occurs, necessarysteps that could solve the problem should be taken, Nguyen Duc Vinh, thedepartment’s head, said at a healthcare conference held in Ho Chi Minh City on August21.

“Maternal and neonatal mortality is unavoidable,but it is very important that health officials seek methods to solve medicalerrors to reduce the mortality rate,” Vinh said.

Medically adverse events are defined as aninjury caused by medical management rather than by the underlying disease orcondition of the patient, according to the Florida State University College ofMedicine’s website.

According to the department’s statistics, 134medically adverse events were reported between 2016 and 2018. Of these, 45caused maternal mortalities and 16 neonatal mortalities.

Vinh blamed the problem on overcrowding ofpatients at hospitals, and lack of compliance with professional regulationsissued by hospitals and the Ministry of Health. The poor capacity of healthofficials is another problem, he added.

In many provinces, for instance, doctors havefailed to detect abnormal signs while examining pregnant women, and severalwomen have been treated for abnormal signs when there were none.

Potential signs of postpartum haemorrhage,uterine rupture and hypertension have also not been detected in time.

Dr Nguyen Ba My Nhi, Deputy Director of Tu DuObstetrics Hospital, told Vietnam News that postpartum haemorrhage, puerperaleclampsia, uterine rupture and puerperal sepsis are the leading causes ofmaternal mortality in Vietnam. Hospitals throughout the country continue to seea large number of patients.

The Tu Du Hospital, for instance, last yearadmitted 400 patients with postpartum haemorrhage caused by placenta accreta,which was abnormally attached to the inside of the uterus. The figure hadincreased from 130 in 2013.

Nhi blamed the increase on the increasing numberof C-section operations.

Another leading cause of maternal mortality ispuerperal sepsis, although the complication can be treated with antibiotics.However, multiple antibiotic resistance is at a high level in Vietnam comparedto other countries.

The hospital admits 70,000 pregnant women fordelivery every year, Nhi said, adding that more than 40 percent of them have aC-section.

“The rate for C-sections is high. Duringsurgery, there is potential for a medically adverse event,” she added.

Dr Le Nguyen Nhat Trung of the city’sPaediatrics Hospital 2 said that doctors at the hospital and others in the cityhave provided professional training for hospitals in the southern and centralregions, and the Central Highlands.

The quality of treatment, however, in theseregions has not improved because of the shortage of doctors, nurses andequipment.

Gia Lai Paediatrics Hospital has 40beds, and five doctors and nine nurses who provide neonatal health careservices, but the province has 15,000 births a year.   

The hospital also does not have sufficientequipment to meet demand, Trung said.

Kon Tum General Hospital has only onedoctor specialising in neonatal care, which is one of the causes for medicallyadverse events, he said.

At Dak Lak province’s General Hospital, roomsare narrow and damp so it is difficult to control hospital-acquired infections.

Every year, the hospital has more than 140newborns who die and nearly 150 cases are transferred to hospitals fortreatment in the city.

Dr Nguyen Kien Mau of the city’s PaediatricsHospital 1 said that nearly 80 percent of newborns who died at the hospital hadbeen transferred from provincial-level hospitals.

Nhi of the Tu Du Hospital said that unsafetransfer from other hospitals had also occurred, resulting in injury orfatality.

Trung suggested that hospitals in provincesshould recruit more doctors and nurses, as well as buy new medicalequipment. 

To reduce medical adverse events, the Tu DuHospital has created a management process for them, according to Nhi.

“When an event occurs, the hospital’s managersand staff have to question why, how and what, so they can seek solutions,” sheadded.

Moreover, managers of the hospital shouldencourage staff and doctors to speak up and report medically adverse events sothey can arrive at the proper solutions.

In the past, no doctor had reported such adverseevents, but last year, 40 percent of the hospital’s doctors did so.

“Mistakes are stepping stones to success,” Nhiadded.

Like the Tu Du Hospital staff, PaediatricsHospital 2 staff also reports adverse events online and sends documents to thehospital’s managers every day if such events occur. 

In addition, the hospital frequently openstraining courses to improve staff capacity and healthcare quality.

More investment in modern equipment isconsidered one of the solutions to curb the number of medically adverse events,according to the hospital.

Moreover, the attitude of health staff towardpatients and communication with patients and their relatives about health problemsneeds to be improved.-VNS/VNA
VNA

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