Epidemiological Surveillance of Fetal and Neonatal Mortality in Peru

Session: Innovative and Collaborative Regional Response to Improved Newborn Surveillance in Latin America and the Caribbean

Presenter: Jeannette Avila Vargas-Machuca, Ministry of Health of Peru
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Background: Beginning in 2010, Peru initiated the implementation of epidemiological surveillance of fetal-neonatal mortality with the objectives of determining the magnitude, trends, and causes of fetal-neonatal death and in order to address and improve quality of care.

Methodology: The surveillance program includes i) weekly mandatory reporting of fetal-neonatal deaths in all health establishments; ii) investigation of preventable hospital deaths; and iii) notification of sentinel hospital cases (asphyxia, respiratory difficulty, and sepsis).

Results: Using this surveillance information 1) perinatal-neonatal deaths are epidemiologically categorized, and risk situations have been identified; today the greatest concentrations of preventable newborn deaths are known to be in the rural mountain districts, marginally poor urban, and rural jungle districts. 2) The causes of neonatal death are differentiated by direct and indirect factors. 3) Estimation of the national neonatal mortality rate (12.8 per 1000 live births); and 4) Contribution to the development of two important national documents, the National Plan to Reduce Neonatal Deaths and the Plan Welcome to Life, addressing late neonatal mortality in poor districts. After five years of experience, surveillance systems need ongoing improvement. Case definitions will be incorporated at the community level to facilitate the differentiation between antepartum and intrapartum deaths, and neonatal deaths caused by asphyxia, infections, prematurity, and lethal congenital anomalies will be classified. The quality of care indicators have been updated and the system for immediate notifications has been improved.

Conclusion: Surveillance has permitted a deeper understanding of the fetal-neonatal mortality situation in Peru and has allowed for the redirection of intervention strategies for its reduction.