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Sierra Leone MDSR Report: 2016

Background

The national Maternal Death Surveillance and Response (MDSR) system was established in Sierra Leone in 2015. The objective of the MDSR system is to count and review maternal deaths, in order to identify causes and contributing factors, and to inform interventions to prevent future deaths.

This first national MDSR report highlights progress towards institutionalisation of MDSR; presents an overview of maternal deaths from January to December 2016; and includes recommendations for improving MDSR implementation and to address the main causes of maternal deaths. Continue reading

Using data to prevent maternal deaths in crisis settings

Triggers and chain of events leading to maternal deaths vary greatly according to contexts in humanitarian settings. We really need to dig up the issues. A systematic review of individual events is essential to take appropriate, life-saving corrective measures. You just need a few reports to understand what is happening, and you can do a lot to change the situation” – Nadine Cornier.
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Every maternal death has a story to tell and should be counted, so that appropriate responses can be developed to prevent similar deaths. But how do we do so effectively and in a timely manner in settings where health systems are disrupted and populations are displaced? Continue reading

New MDSR reports galvanise action to improve quality of care in Malawi Northern Zone

As part of its efforts to improve accountability for women and children’s health, Malawi classified maternal death as a notifiable event in 2003, and the National Committee on Confidential Enquiry into Maternal Deaths (NCCEMD) was established in 2009. Like many other countries, from 2013, Malawi moved from maternal death reviews (MDRs) to the more robust system of maternal death surveillance and response (MDSR), which entails not only that maternal deaths are notifiable, but also places greater emphasis on response, and on the monitoring and evaluation of MDSR itself. Continue reading

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Is scaling-up community maternal verbal autopsies a viable approach to inform action to reduce maternal mortality?

Key messages

  • Community verbal autopsies are recommended in Maternal Death Surveillance and Response systems. Potentially they can inform action to prevent further deaths by improving our understanding of: The circumstances surrounding deaths occurring in the community; individual and community-level factors contributing to delays for those deaths occurring at facilities; and family perspectives of treatment received at facilities. However, undertaking verbal autopsies at scale may not always be feasible.
  • Maternal deaths are rare events and, particularly in settings that are experiencing rapid increases in institutional delivery rates, are increasingly occurring in facilities.
  • Community verbal autopsies entail a high training cost, with large numbers of community health workers each covering relatively small geographical areas. Their low skill, high turnover and infrequency of conducting verbal autopsies generate poor quality information and limited new insights. The collection of data with limited use at a sensitive time also raises ethical concerns.
  • In low resource settings, other strategies could be considered to achieve the primary purposes of maternal death surveillance and response, for example strengthening community based vital registration systems for better notification of deaths; strengthening facility-based maternal death reviews with a focus on the community delays contributing to facility-based deaths; and intermittent qualitative research by skilled researchers.

Continue reading

National MDSR Annual Report 2008 EFY (2015-16)

This is the second national report on maternal death surveillance and response (MDSR) data from Ethiopia. It presents data reported to the national MDSR database in the Ethiopian Financial Year (EFY) 2008 (2015-16). In 2008 EFY, 633 maternal deaths were reported; this is 6% of the expected maternal deaths and an increase from 387 deaths between 2006 and 2007 EFY (2013-15).
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The MDSR system has now been rolled-out to all regions in the country and includes data on deaths in the community and in facilities. In 2008 EFY the number of hospitals in Ethiopia grew significantly. Health-facility deaths now make up nearly 40% of investigated cases, which has contributed to an increase of reported events for 2008.

This expansion of the system leading to a larger number of community and facility data in 2008 makes it too early to compare the data from both reporting periods. This report should, therefore, be considered on its own. However, for future reports it is expected that the data will be used to determine patterns and trends in maternal mortality over time.

The feature of this report is a new response section with examples of actions from community level to national level in response to the review of maternal deaths and the data contained in the 2008 EFY MDSR Report.

Haemorrhage continues to be the leading cause of death with 42% of maternal deaths due to obstetric haemorrhage. The provision of trained staff and appropriate equipment is necessary to manage obstetric haemorrhage. All women should also be encouraged to use antenatal care services and be offered iron during their pregnancy to help prevent haemorrhage.

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Click here to download the report (PDF).

How legal and policy frameworks support MDSR in Jamaica

Image_map of JamaicaProfessor Affette McCaw-Binns, a Reproductive Health Epidemiologist at the University of the West Indies (Mona) and Dr Simone Spence, Director of Family Health Services at the Ministry of Health in Jamaica explain how legislation and policy strengthened the reporting of maternal deaths in Jamaica. This case study describes how the policy framework was amended to improve the reporting of maternal deaths and how other interventions implemented simultaneously together strengthen the maternal death surveillance and response (MDSR) system. Continue reading

Nigeria | MPDSR scorecard from Lagos State

In Nigeria, the Evidence for Action (E4A)-MamaYe programme has continued to provide extensive support to the iImage_Cover of scorecardmplementation of maternal and perinatal death surveillance and response (MPDSR) at sub-national levels from October to December 2016.

The programme assisted the Lagos State MPDSR Committee and the Lagos State Accountability Mechanism for maternal, newborn and child health (LASAM) to develop the State-level Facility MPDSR Scorecard. Data from May to July, 2016 from 17 general hospitals with MNCH services were submitted and presented in the scorecard (see excerpt, below). Continue reading

The power of communities: strengthening maternal death reporting…and much more!

  • Doubling the number of maternal deaths identified.
  • Accurate and cost-efficient method of measuring the maternal mortality ratio.
  • Strengthened relationships and trust between health facilities and communities they serve.
  • Community actions to prevent future deaths: establishing mobile antenatal care clinics, arranging community meetings to explore traditional beliefs and mobilising funds for bicycle ambulances.

9931220574_d3c293d629_cThese are some of the key results from a community-linked maternal death review (CLMDR) pilot that ran from 2011-2012 in Mchinji district, Malawi.  Presented by Dr Tim Colbourn, Lecturer in Global Health Epidemiology and Evaluation at the University College London (UCL) Institute for Global Heath, the results of the study show the importance of involving communities in the process of identifying maternal death and acting on the recommendations of maternal death review and surveillance (MDSR) systems. Continue reading

Ethiopia MDSR Resource Hub

Image_Ethiopia Quarterly MDSR newsletters_Banner_PostVisit the new Ethiopia MDSR Resource Hub on the Action Network website!

Read what the Minister of Health thinks about the power of MDSR. Watch a short film of how MDSR is saving lives in Ethiopia. Browse the first National Report on MDSR data; download the policy briefs on quality of care and strengthening maternal death surveillance; and much more!

Seminar Series: 2017

Innovations in maternal and perinatal health in humanitarian settings: Exploring evidence and innovations to improve maternal and newborn survival among populations affected by humanitarian crises 

This new seminar series will take place at the London School of Hygiene and Tropical Medicine (LSHTM) in collaboration with the Global MDSR Action Network and LSHTM’s Health in Humanitarian Crises Centre and The Centre for Maternal, Adolescent, Reproductive, and Child Health (MARCH). Continue reading