实施孕产妇死亡监测和应对(MDSR)中的法律问题:范围界定审查。

IF 2.9 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Mulu Beyene Kidanemariam, Ingrid Miljeteig, Karen Marie Moland, Andrea Melberg
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引用次数: 0

摘要

孕产妇死亡监测和应对(MDSR)系统旨在持续识别和审查所有孕产妇死亡案例。其目的是帮助各国了解孕产妇死亡的规模和分布情况,确定其原因,并通报应对挑战的纠正措施。尽管许多低收入或中等收入国家越来越多地采用 MDSR,但其实施面临各种挑战,包括法律挑战。本次范围界定审查旨在了解在实施 MDSR 过程中出现的法律问题和挑战。它采用了 Bain 和 Kongnyuy 框架,将法律问题分为数据、人员、调查结果的使用和法律监管。我们从七个数据库中检索了文献,并进行了额外的在线搜索。我们纳入了 2010 年至 2022 年 11 月间以英文发表的、报告在实施 MDSR 过程中出现的法律问题的研究。在筛选出的 1,174 项研究中,我们选择了 31 项进行审查。审查强调了研究界对 MDSR 法律层面的关注有限。它还记录了缺乏对该系统的有效实施至关重要的适当法律框架的情况。对信息隐私的保障不足和缺乏保密性加剧了普遍的被指责感,主要是在卫生工作者中。因此,有报告称,普遍存在孕产妇死亡原因少报和故意错误归因、防御性转诊以及脱离 MDSR 流程的情况。我们建议实施国通过适当的法律规范 MDSR 数据的收集和使用,并从法律上确保 MDSR 数据仅用于预期目的。卫生系统需要有适当的投诉处理机制,以防止 MDSR 被滥用。考虑到 MDSR 涉及多方面的法律问题,今后关于 MDSR 实施情况的研究最好有法律专家参与。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Legal issues in the implementation of Maternal Death Surveillance and Response: a scoping review.

The Maternal Death Surveillance and Response (MDSR) system is designed to continuously identify and review all maternal deaths. It aims to help countries understand the scale and distribution of maternal deaths, identify their causes, and inform corrective measures to address the challenge. Despite the growing adoption of the MDSR by numerous low- or middle-income countries, its implementation faces various challenges, including legal ones. This scoping review was conducted to map legal issues and challenges that arise during the implementation of the MDSR. It adapted the Bain and Kongnyuy framework, categorizing legal issues into data, people, use of findings, and legal regulation. Literature was retrieved from seven databases, complemented by additional online searches. We included studies published in English between 2010 and November 2022 that report on legal issues arising during the implementation of MDSR. Out of 1174 studies screened, 31 were selected for review. The review highlighted the limited attention given to the legal dimension of the MDSR by the research community. It also documented the lack of adequate legal framework essential for the system's effective implementation. Inadequate safeguards for informational privacy and the lack of confidentiality reinforce a prevalent sense of being blamed, mainly among health workers. Consequently, widespread under-reporting and intentional misattribution of causes of maternal death, defensive referrals, and disengagement from the MDSR process were reported. We recommend that implementing countries regulate the gathering and use of MDSR data through appropriate laws and legally ensure that the MDSR data are only used for the intended purpose. Appropriate complaint-handling mechanisms are needed in health systems to prevent the misuse of the MDSR. Future studies on MDSR implementation would benefit from involving legal experts, considering the multifaceted legal dimensions of the MDSR.

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来源期刊
Health policy and planning
Health policy and planning 医学-卫生保健
CiteScore
6.00
自引率
3.10%
发文量
98
审稿时长
6 months
期刊介绍: Health Policy and Planning publishes health policy and systems research focusing on low- and middle-income countries. Our journal provides an international forum for publishing original and high-quality research that addresses questions pertinent to policy-makers, public health researchers and practitioners. Health Policy and Planning is published 10 times a year.
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