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      EviSIP: using evidence to change practice through mentorship – an innovative experience for reproductive health in the Latin American and Caribbean regions

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          ABSTRACT

          Maternal mortality is unacceptably high in our region. In 2015, the Latin American Center for Perinatology and Women´s Reproductive Health (CLAP) created a regional network of institutions including 16 countries, committed to improving epidemiological surveillance and healthcare of women in a situation of abortion or near miss event, using a common platform, the Perinatal Information System (SIP). The objective of the current pilot project was to test a new method of study called EviSIP (Evidence from SIP), a method of generating information on maternal near miss and abortion for the region. We describe the implementation of this initiative in reproductive healthcare facilities using SIP. Junior researchers/clinicians from these countries were included, along with expert researchers in reproductive health from across the world. Articles were produced with data on maternal near miss and abortion gathered from the SIP of each participating sentinel center; and recommendations from experts. EviSIP was the first joint workspace to discuss patient outcomes after treatment of abortion or near miss cases, with data analysis of each Sentinel Center; discuss and analyze data among centers, at a country and regional level; discuss the main outcomes and their impact on changing procedures and policies; strengthen the operational research capacity of the centers; develop and encourage the publication of scientific articles. The EviSIP initiative also promoted training of healthcare professionals in research. EviSIP provided a unique opportunity to train for research and mentorship and was pivotal to the production of scientific knowledge of reproductive health in the region.

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          Maternal near miss--towards a standard tool for monitoring quality of maternal health care.

          Maternal mortality is still among the worst performing health indicators in resource-poor settings. For deaths occurring in health facilities, it is crucial to understand the processes of obstetric care in order to address any identified weakness or failure within the system and take corrective action. However, although a significant public health problem, maternal deaths are rare in absolute numbers especially within an individual facility. Studying cases of women who nearly died but survived a complication during pregnancy, childbirth or postpartum (maternal near miss or severe acute maternal morbidity) are increasingly recognized as useful means to examine quality of obstetric care. Nevertheless, routine implementation and wider application of this concept in reviewing clinical care has been limited due to the lack of a standard definition and uniform case-identification criteria. WHO has initiated a process in agreeing on a definition and developing a uniform set of identification criteria for maternal near miss cases aiming to facilitate the reviews of these cases for monitoring and improving quality of obstetric care. A list of identification criteria was proposed together with one single definition. This article presents the proposed definition and the identification criteria of maternal near miss cases. It also suggests procedures to make maternal near miss audits operational in monitoring/evaluating quality of obstetric care. The practical implementation of maternal near miss concept should provide an important contribution to improving quality of obstetric care to reduce maternal deaths and improve maternal health.
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            Better reporting of randomised controlled trials: the CONSORT statement.

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              Network for Surveillance of Severe Maternal Morbidity: a powerful national collaboration generating data on maternal health outcomes and care.

              To identify cases of severe maternal morbidity (SMM) during pregnancy and childbirth, their characteristics, and to test the feasibility of scaling up World Health Organization criteria for identifying women at risk of a worse outcome.
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                Author and article information

                Journal
                Glob Health Action
                Glob Health Action
                Global Health Action
                Taylor & Francis
                1654-9716
                1654-9880
                1 September 2020
                2020
                : 13
                : 1
                : 1811482
                Affiliations
                [a ]CLAP/WR-PAHO/WHO – Latin American Center of Perinatology/Women´s Health and Reproductive Health, Pan-American Health Organization; , Montevideo, Uruguay
                [b ]University of Campinas School of Medicine and CEMICAMP (Center for Studies of Reproductive Health in Campinas); , Campinas, Brazil
                [c ]Department of Sexual and Reproductive Health and Research, Preventing Unsafe Abortion Team. World Health Organization; , Geneva, Switzerland
                Author notes
                CONTACT Suzanne J. Serruya serruyas@ 123456paho.org Centro Latinoamericano de Perinatología, Salud de la Mujer y Reproductiva/Organización Panamericana de la Salud; , MontevideoCP 11300, Uruguay

                On behalf of the CLAP Network Working Group

                Author information
                https://orcid.org/0000-0003-1371-4558
                https://orcid.org/0000-0001-9914-7130
                https://orcid.org/0000-0001-5455-1236
                https://orcid.org/0000-0003-0662-9742
                https://orcid.org/0000-0001-8280-3234
                https://orcid.org/0000-0003-1032-487X
                https://orcid.org/0000-0003-1282-9337
                https://orcid.org/0000-0002-3574-4160
                https://orcid.org/0000-0003-2159-2570
                https://orcid.org/0000-0001-5219-1003
                https://orcid.org/0000-0002-8543-4996
                https://orcid.org/0000-0003-1285-8445
                Article
                1811482
                10.1080/16549716.2020.1811482
                7480421
                32867629
                d55837e1-c198-49e6-b634-9436c528f6eb
                © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Figures: 3, References: 22, Pages: 1
                Categories
                Research Article
                Capacity Building

                Health & Social care
                research method,mentorship,reproductive health,network,electronic health records,sip,perinatal information system

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