The results of the first perinatal mortality audit in North Macedonia, released today, highlight areas that need to be addressed in order to improve the care for mothers and their babies during pregnancy, childbirth and the neonatal period. This audit, conducted based on the data from 2019, provides important insights and evidence-based recommendations that can be used both to address system errors and barriers and to identify and praise points of strength. “Successfully reaching the goal of providing evidence-based health care at the appropriate health facility, when it’s needed, will mean more equal opportunities for every community in North Macedonia and ultimately, healthier women and children,” said Dr Elizabeta Georgievska Pendarovska, First Lady of North Macedonia, at the launching event of the report.
North Macedonia takes action to continue reducing perinatal deaths
The number of perinatal deaths, or stillbirths and deaths in the first week of life, has systematically decreased in North Macedonia over the past three decades. After an upsurge in neonatal mortality in 2015, swift action was taken by the Ministry of Health with technical support from WHO, United Nations Population Fund (UNFPA) and UNICEF. A subsequent in-depth assessment clarified ways to strengthen the health system and fast-track improvements in maternal and newborn health outcomes.
As a result, the Ministry of Health established the national Safe Motherhood Committee and the Perinatal Mortality Audit Working Group to ensure a better quality of services for mothers and babies. In addition, the Perinatal Care Master Plan 2020–2030 was launched in 2020. It provides a consolidated analysis of the perinatal care delivery system, evidence-based recommendations for risk-appropriate care, and the organization and optimization of maternal and newborn services via a well-prepared workforce, strong quality assurance system and the strengthening of the health information system.
The 2019 perinatal mortality audit is an important means for North Macedonia to reach these goals, and both WHO and UNICEF are committed to continue their collaboration with the Ministry of Health and other partners.
“WHO in North Macedonia supported the perinatal audit in order to ensure quality of care,” said Dr Jihane Tawilah, WHO Representative to North Macedonia, at the launching event of the perinatal mortality audit report. “This audit makes it possible for health system managers to understand the causes of death and the contributing factors, so they are able to take corrective action to improve the quality of care.”
“UNICEF is strongly committed towards the objective of the Master Plan for strengthening the continuity of care and harnessing digital care technologies by forming a new model of perinatal care networks to include hospitals, primary health care gynecologists and patronage nurses,” said Patrizia Di Giovanni, UNICEF representative to North Macedonia.
Recommendations based on the solid analysis of facts and figures
The analyses of the perinatal deaths identified and reviewed gaps and bottlenecks in the quality of care for pregnant women and during childbirth, postnatal and neonatal care. Alongside other recommendations, emphasis was given to the importance of information among providers of antenatal care on the screening for several important maternal conditions. Such information is crucial in planning the appropriate care for a mother and her child.
Other fundamental recommendations, based on the audit findings, relate to the training of health care professionals, treatment guidelines, criteria for performing a caesarean section in the case of a stillbirth or neonatal death, and timely, correct interventions to prevent unnecessary complications.
Essential newborn care, which is a set of effective, low-cost interventions, is another important recommendation for North Macedonia. Thermal care, screening for temperature, and breast feeding can be implemented at almost any setting and are proven to enhance neonatal outcomes.
WHO in North Macedonia will continue its support of the perinatal mortality auditing process and will facilitate the implementation of the Perinatal Care Master Plan 2020–2030, in collaboration with UNICEF, UNFPA and other partners. All joint actions aim to achieve the best possible health outcomes for mothers and newborns.
