Week 5

Bowden, S., Braker, K., Checchi, F., & Wong, S. (2012). Implementation and utilisation of community-based mortality surveillance: a case study from Chad. Conflict and Health, 6, 11.     http://doi.org.libproxy.chapman.edu/10.1186/1752-1505-6-11

So let me start this by confessing that I severely underestimated 'subject specific database' research on Wednesday evening as Dr. Dunn talked us through it in class. Upon conducting a few quick classroom database searches with subjects like "social science" and "healthcare communication" I had pretty much resigned this assignment to being completed with the assistance of my research assistant and mentor, Mr. G.O. Ogle. Of course,  I'd be sure to write that I had literally given the Leatherby databases the 'ol college try'. So I was really quite surprised to find this article and several others like it when I went back into the databases and searched using the 'Nursing' subject (an idea I got from the class handout on database subjects...and from Daniella in class but don't tell her I admitted she told me so). Additionally, unlike many other research resources I’ve used in studying this topic, this article does not group it’s information about Chad into a compiled study or analysis along with other countries in the Sub-Saharan region. Rather, it’s dedicated to analyzing mortality surveillance in Chadian healthcare systems exclusively.

This article confirmed a suspicion that I had, based on other research, that maternal and child mortality reporting processes were not up to par in Chad. Some of the reasons that it specifically cites have been added to my body of research. These reasons are, a lack of consistent, standardized processes for mortality documentation, making the vital record easier to overlook or more likely to be reported incorrectly. Also the lack of community health care workers contributes to improper reporting and documentation, especially in emergency situations when workers are task saturated. Another reason that was discovered was illiteracy and language barriers between healthcare workers and patients. A considerable amount of Chadians are illiterate and there are currently approximately 120 languages and dialects spoken in the country. Finally, the analyst recounted that violence and security incidents significantly interrupted the records keeping process on multiple occasions. Six different times during the four-year study they noted that mortality data was not recorded for a whole month due to the security threats.

With the article’s special emphasis on record keeping practices for women and children there was the implication that these practices were particularly more lax. This concept invoked some questions that I’ve had now for a few weeks but have not yet delved into answering. After the information I’ve learned in this article I want to finally commit to researching the political and cultural mindsets concerning the value of women and children in Chad and the behaviors, customs, and laws that are or are not in place protecting them or contributing to their mortality.