MATERNAL AND PERINATAL MORTALITY INDICATORS (2020–2024) AS A MANAGEMENT TOOL FOR OBSTETRIC CARE
Keywords:
maternal mortality; perinatal mortality; obstetric care; management; quality improvement; clinical audit; three delays model; referral system.Abstract
Objective: to identify organizational and managerial determinants associated with maternal and perinatal mortality and to substantiate priorities for quality management in obstetric services. Materials and methods: a retrospective analysis of official statistics for 2020–2024 and expert case review materials for maternal and perinatal deaths, including facility level (I–III), referral pathways, transfer multiplicity, key time intervals, and protocol adherence. Results: a substantial proportion of adverse maternal outcomes occurs outside level III facilities; transfers are often late and multi-step. Leading maternal causes include obstetric hemorrhage, hypertensive disorders of pregnancy, sepsis, and extragenital diseases. Perinatal losses are mainly linked to prematurity, hypoxia/asphyxia, infections, and congenital anomalies; during the period, 40,603 perinatal deaths were registered, with more than 60% occurring at antenatal and intrapartum stages. Conclusion: reducing preventable losses requires standardized readiness for emergency obstetric care, early risk stratification, optimized referral logistics, and strengthened clinical audit with feedback across all levels
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