1 INTRODUCTION

Many low- and middle-income countries (LMICs) with high maternal mortality rates lack reliable routinely collected data on the quality of care provided to women giving birth in facilities nationwide and information when a death occurs. Although global efforts have been made to address the high numbers of maternal and perinatal deaths (e.g. by increasing the number of women who access health facilities for pregnancy care and delivery), this has not translated into reducing mortality.^{1, 2}

Despite reaching health facilities, many women and their babies still die because of delays in receiving quality care.^{3, 4} Health information systems designed to assess quality of care and outcomes for women and their babies can play a crucial role in facilitating timely interventions, as part of a continuing quality improvement process to enhance maternal and newborn care. Nigeria is one of the highest contributors to maternal and perinatal mortality worldwide, with approximately 67 000 annual maternal deaths and stillbirth rates of 43 per 1000 total births.^{5, 6} However, as a tool for improving maternity care, the collation of actionable routine healthcare data is hindered by the lack of harmonised data and by the poor quality of data available in Nigeria. This limitation impedes the ability of researchers to pinpoint and address gaps in the quality of care at regional and national levels.

Recognising this limitation, the World Health Organization (WHO) in partnership with the Nigerian Federal Ministry of Health (FMOH) established a nationally representative electronic database, the Maternal and Perinatal Database for Quality, Equity and Dignity (MPD-4-QED), in referral-level hospitals across Nigeria, with the aim of monitoring the quality of maternal and early newborn care and outcomes for women and their babies. In this article, we present the process for setting up the database, challenges encountered in its implementation, lessons learned and prospects of the programme to assist other countries that share similar health system characteristics in establishing nationally representative facility-based data collection systems.

中文翻译：

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建立孕产妇和围产期质量、公平和尊严数据库 (MPD-4-QED) 计划：过程、挑战、教训和前景

1 简介

许多孕产妇死亡率较高的低收入和中等收入国家 (LMIC) 缺乏可靠的常规收集数据，无法了解全国各地设施中为妇女分娩提供的护理质量以及死亡发生时的信息。尽管全球已做出努力来解决孕产妇和围产期死亡人数高的问题（例如，通过增加使用卫生设施接受妊娠护理和分娩的妇女人数），但这并没有转化为死亡率的降低。^{1, 2}

尽管到达了医疗机构，许多妇女及其婴儿仍然因得不到优质护理而死亡。^{3, 4}旨在评估妇女及其婴儿的护理质量和结果的卫生信息系统可以在促进及时干预方面发挥至关重要的作用，作为加强孕产妇和新生儿护理的持续质量改进过程的一部分。尼日利亚是全球孕产妇和围产儿死亡率最高的国家之一，每年约有 67 000 名孕产妇死亡，死产率为每 1000 名新生儿中有 43 名死产。^{5, 6}然而，作为改善孕产妇护理的工具，可操作的常规医疗保健数据的整理受到缺乏统一数据和尼日利亚可用数据质量差的阻碍。这种限制阻碍了研究人员查明和解决区域和国家层面护理质量差距的能力。

认识到这一局限性，世界卫生组织 (WHO) 与尼日利亚联邦卫生部 (FMOH) 合作建立了一个具有全国代表性的电子数据库，即孕产妇和围产期质量、公平和尊严数据库 (MPD-4-QED)，尼日利亚各地的转诊级医院，旨在监测孕产妇和早期新生儿护理的质量以及妇女及其婴儿的结局。在本文中，我们介绍了建立数据库的过程、实施过程中遇到的挑战、经验教训和该计划的前景，以帮助具有类似卫生系统特征的其他国家建立具有国家代表性的基于设施的数据收集系统。