World Patient Safety Day 2021: Act now for safe and respectful childbirth 

BY Dr. Charuni Kohombange 

Adopting the World Health Assembly resolution WHA72.6 on “Global action on patient safety”, World Patient Safety Day was established in 2019 by the 72nd World Health Assembly. The day is celebrated across the globe, focusing on the fundamental principle of medicine, “first do no harm”. The overall objectives are to enhance global understanding of patient safety, increase public engagement in healthcare safety, and promote global action to prevent and reduce avoidable harm in healthcare. Each year a theme is selected to shed light on a priority area critical to patient safety and ultimately the achievement of universal health coverage. 

Giving consideration to the significant burden of risks and harm women and newborns are exposed to when receiving unsafe care during childbirth, the World Health Organisation (WHO) has selected the theme “Safe maternal and newborn care”, for World Patient Safety Day 2021. Through the slogan “Act now for safe and respectful childbirth!”, WHO invited all stakeholders to accelerate the actions necessary for ensuring safe and respectful childbirth. 

National event of World Patient Safety Day 2021 

The national event of World Patient Safety Day 2021 was held on 17 September at the auditorium of the Directorate of Healthcare Quality and Safety with a limited number of health sector officials and the rest of participants joining the event virtually. Ministry of Health Deputy Director – General Medical Services I (DDG-MS I) Dr. Lal Panapitiya delivered the welcome speech inaugurating the event. Dr. Panapitiya highlighted that, during the current pandemic, the healthcare services of Sri Lanka has taken up immense efforts to safeguard the wellbeing of mothers and the newborns. Identifying dedicated treatment centres including intensive care units and high dependency units for pregnant mothers who are affected with Covid-19 and providing optimum newborn care for those patients since the initiation of the first wave, improving and ensuring prenatal and postnatal care of mothers and newborns though Medical Officers of Health and Public Health Midwifes, introducing vaccination for pregnant mothers to prevent Covid-19 infection and allowing pregnant mothers and mothers with children below one year to stay at home, giving special permission to exclude from office duties were mentioned as few of the steps taken. 

Directorate of Healthcare Quality and Safety Director (Covering up) Dr. Dewanee Ranaweera presented the achievements of the directorate and explained the programme lineup. 

Minister of Health Keheliya Rambukwella joined the meeting virtually as the chief guest, and conveyed his gratitude to the Directorate of Healthcare Quality and Safety for conducting this event and providing a platform for the healthcare institutions across the country to stage their best practices and recognise their efforts. Further, he appreciated the tireless efforts of the healthcare workers for their selfless dedication in the battle with Covid-19. 

Director General – Health Services (DGHS) Dr. Asela Gunawardana addressed the gathering and stated that the “Safe maternal and newborn care” theme was relevant, considering the significant burden of risks and harm women and newborns are exposed to due to unsafe care, compounded by the disruption of essential health services caused by the pandemic. He further stated that the success Sri Lanka has made in the field of maternal and child health are well recognised throughout the world. However, there is still room to improve the services. 

Ministry of Health Secretary Dr. S.H. Munasinghe elaborated the objectives of Patient Safety Day as; raising awareness on the issues of maternal and newborn safety, particularly during childbirth, engage multiple stakeholders and adopt effective and innovative strategies to improve maternal and newborn safety, call for urgent and sustainable actions by all stakeholders to scale up efforts, reach the unreached and ensure safe maternal and newborn care, particularly during childbirth and advocating the adoption of best practices at the point of care to prevent avoidable risks and harm to all women and newborns during childbirth. 

Additional Secretary – Medical Services Dr. Sunil de Alwis explained the difficulties faced by health staff in securing safety during child birth especially at resource limited settings. He emphasised the importance of training on essential obstetric care and best practices to each level of healthcare and also highlighted the importance of paying attention to the emotional aspect of pregnant mothers especially during the childbirth. 

WHO Representative to Sri Lanka Dr. Alaka Singh joined the meeting virtually and delivered her speech. She mentioned that recently the WHO has taken targeted action to enhance patient safety, including the Region’s Strategy for Patient Safety 2016-2025 and the recently adopted Global Patient Safety Action Plan 2021-2030. According to Dr. Singh, globally, every year, an estimated 134 million adverse events due to unsafe care occur in hospitals in low and middle-income countries, contributing to around 2.6 million deaths. Approximately 810 women die every day from preventable causes related to pregnancy and childbirth, in addition to around 6700 newborns. An estimated 2 million stillbirths occur annually, over 40% of them during labour. 

Further she stated that in the South East Asian region and across the world, most stillbirths and maternal and newborn deaths could be avoided through the provision of safe and quality care by skilled health professionals working in supportive environments. Dr. Singh mentioned that due to the free health system and for the strong public health system of Sri Lanka the maternal mortality rates are being dramatically reduced and she stated that Sri Lanka has set an example for the rest of the world. 

The keynote address was delivered by the Director – Maternal and Child Health Dr. Chithramalee de Silva on the topic “Safe Maternal and Childcare in Sri Lanka”. According to her presentation, maternal and newborn deaths have been dramatically reduced from 2001 up to now. However, due to the pandemic, the number of maternal deaths has increased when compared to the past few years. She emphasised that quality care is the way forward to reduce this trend. Dr. de Silva pointed out the importance of ensuring supplies, maintaining supportive services, proper waste management, infection control, documentation and monitoring and evaluation of outcome indicators in assuring the quality in healthcare institutions. 

National action plan for medication safety 

Medication safety has become a global issue contributing to an unacceptably high number of deaths and disabilities in the world. WHO has announced medication safety as a global patient safety challenge and all countries were requested to make a pledge to reduce medication errors and develop a National Action Plan to reduce severe harm due to medication errors by 50% within five years. Addressing this requirement, University of Colombo Professor in Pharmacology at the Faculty of Medicine Prof. Priyadharshini Galappatthy prepared the draft national action plan for medication safety. 

Recognition of best practices of healthcare institutions 

The Directorate of Healthcare Quality and Safety has conducted a competition among healthcare institutions to select the best practices related to safe maternal and newborn care. Colombo North Teaching Hospital, Ragama was awarded the Best Practice Gold Award in the Line Ministry institution category, for their innovative project of a baby guard to prevent babies falling from beds while receiving phototherapy. Representing the Quality Management Unit of Ragama Teaching Hospital, Dr. Mahesh Perera and Nursing Officer Ms. Alwis presented their innovation. Best Practice Gold Award in the Provincial Ministry category was secured by Base Hospital Udugama for their project on “Active implementation of partogram for safe maternal and newborn care”. Dr. Susantha Fernando, Medical Superintendent of Base Hospital Udugama presented their project. The selection of best practices has been conducted by an independent panel of judges which included all relevant specialties. 

Illuminating the Lotus Tower 

The global campaign for World Patient Safety Day 2021 proposed a wide range of activities to be implemented on and around 17 September 2021, which included lighting up of iconic monuments, landmarks and public places in orange, the theme colour of the campaign. As a tribute to the frontline healthcare workers who struggle through day and night in the battle with Covid-19, the iconic Lotus Tower was illuminated for two hours on World Patient Safety Day 2021. 

(The writer is a Medical Officer at the Directorate of Healthcare Quality and Safety, Ministry of Health)