Institutionalizing district level infant death review: an experience from southern India.

ABSTRACT

Background: An Infant Death Review (IDR) programme was developed and implemented in two districts of Karnataka. Objective: We explored the processes that led to the development of the IDR programme with a view to improving the existing pilot programme and to ensuring its sustainability. Methods: A sequential mixed-methods design was followed in which quantitative data collection (secondary data) was followed by qualitative data collection (in-depth interviews). Quantitative data were entered using EpiInfo (version 3.5.1) software and qualitative data were analysed manually. Results: Apart from ascertaining the cause of infant deaths, the IDR Committee discusses social, economic, behavioural and health system issues that potentially contribute to the deaths. As a result of the IDR programme, key actors perceived an improvement in infant death reporting at district level, the development of a rapport with the local community, and elaboration of a feedback system for corrective actions. This has led to improved health care during pregnancy. Conclusions: We found that involvement of the different stakeholders in planning and implementing the IDR programme offered a platform for collective learning and action. Impediments to the success of the programme need to be addressed by corrective actions at all levels for its future sustainability.