“The healthy future of society depends on the health of the children of today and their mothers.” (WHO, 2005)
Maternal mortality is unacceptably high worldwide. It was estimated that in 2015, 303,000 women died during and following pregnancy and childbirth. Almost all of these deaths occurred in low-resource settings, and most could have been prevented.
In late 2014, PNIPH started its assessment of the Maternal and Child Health registry in Palestine. Early results showed that a substantial amount of data on antenatal, perinatal, and postnatal care was not exchanged between primary and secondary health care facilities, but was mainly used in annual reports. Care providers had to manually record data on paper, and legislation or agreements on health data confidentiality was limited. As a result of this assessment, PNIPH partnered with the Norwegian Institute of Public Health (NIPH) to introduce the Maternal and Child Health (MCH) e-Registry in Palestine. In addition to automated data collection and better monitoring and analysis, the main goal of the e-Registry was to transfer data from the clinical level to the national level to support evidence-based decision making.
The e-Registry was planned and implemented through a consensus-driven process with stakeholders working in maternal and child health. The international needs assessment tool was adapted for the Palestinian context, and four assessments using the tool were completed in collaboration with the Ministry of Health (MoH) and UNRWA in the West Bank and Gaza.
The registry's database was developed to describe existing reproductive health facilities, services, human resources, and infrastructure. Antenatal and postnatal guidelines, as well as corresponding care algorithms, were discussed and updated after a series of meetings with physicians, obstetricians, pediatricians, midwives, nurses, and community health workers. Additionally, a governance structure to protect mothers' and children’s privacy and confidentiality was carefully developed.
As part of PNIPH’s efforts to control quality and ensure sustainability, training courses for users of the registry were planned to include 1,500 health care providers in the West Bank and Gaza.
Due to the poor infrastructure at primary health care clinics throughout Palestine, PNIPH provided clinics with computers, servers, and connectivity supplies, while internet was provided by the MoH.
By the end of November 2017, 186 clinics out of 427 (43.6%) had the needed infrastructure; 145 of which provided MCH services in the West Bank and Gaza using the e-Registry through a structured data entry system using electronic checklists. This helped flag high-risk pregnancies and guide care providers' clinical management.