Table 1 PREMAND project screening tools

Short form RAMOS (Reproductive Aged Mortality Survey) for identifying potential maternal deaths

This is an instrument based on previous work by Geynisman et al. (2011) that demonstrated the use of a subset of the 39-question Reproductive Age Mortality Survey was positively predictive in identifying deaths that were ultimately classified as maternal mortality deaths [28]. The point of this screening tool is to reduce the number of verbal and social autopsies that end up not being cases of maternal mortality, but instead are simply deaths among women of reproductive age. Field workers will train CKIs to administer the RAMOS screening tool whenever they learn of the death if a woman of reproductive age in the community. The questions on the RAMOS screening tool are:

o Was the woman recently pregnant? (Within the past 6 weeks?)

o Was she pregnant when she died?

o Was she bleeding from the vagina?

o Do you think pregnancy had anything to do with her death?

Neonatal Screening Tool for identifying potential neonatal deaths

This is a short instrument to determine if the death of an infant qualifies as a neonatal death. The instrument asks if there was a baby who died, and if yes, did the baby die within 28 days (4 weeks) of its birth.

Maternal Near-Miss Screening Tool for identifying maternal near-misses

This is a checklist developed by the World Health Organization [23] and initially modified for use in Ghana by Tuncalp et al. (2013) for a study of maternal near-misses at Korle Bu Teaching Hospital in Accra [29]. The instrument has been subsequently modified in collaboration with a team of post-doctoral researchers from Ghana led by one of the Co-Directors (CM) of this project for a study of near-misses in the southern part of Ghana conducted during the dry season of 2015 at the Korle Bu Teaching Hospital, the Komfo Anokye Teaching Hospital, and the Cape Coast Regional Hospital (the project is known as MISS– the Maternal and Infant Survival Study). This instrument will allow providers to complete a brief checklist to determine if a woman can be classified as a “near-miss” based upon the answers to a few critical clinical questions.

Neonatal Near-Miss Screening Tool for identifying neonatal near-misses

This is a checklist that has been developed in collaboration with a team of post-doctoral researchers from Ghana led by one of the Co-Directors (CM) of this project for a study of near-misses in the southern part of Ghana conducted in the Spring of 2015 at Korle Bu Teaching Hospital, Komfo Anokye Teaching Hospital, and Cape Coast Regional Hospital (the MISS project, described above). The instrument was developed based on existing neonatal morbidity measures [30] and modeled after the WHO Maternal Near-Miss criteria. The instrument will allow providers to complete a brief checklist to determine if a baby can be classified as a ‘near-miss’ based upon the answers to a few critical clinical questions.