This is the first national report on data from Sierra Leone’s Maternal Death Surveillance and Response (MDSR) system since it was established in 2015. It includes data from 663 maternal deaths between January and December 2016.
This report highlights progress in institutionalising MDSR, gives an overview of maternal deaths from 2016 and includes recommendations for improving MDSR implementation as well as solutions to address the main causes of maternal deaths.
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).
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.
Professor 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 →
In Nigeria, the Evidence for Action (E4A)-MamaYe programme has continued to provide extensive support to the implementation 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 →
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.
These 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 →
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!
In South Africa, perinatal deaths are defined as all stillbirths and early neonatal deaths (from live birth to seven full days after birth). While the country has accepted the definition* of reporting and recording all deaths (foetal and neonatal) weighing more than 500 grams, it is uncertain if all hospitals where deliveries take place are correctly reporting all deaths weighing less than 1000 grams, especially stillbirths. This may be influenced by a South African law that requires all defined stillbirths to have a burial and notification of death. In rural areas and busy hospitals, this may be seen as labour intensive for already overworked staff. Continue reading →
The mortality audit (or review) process is an established tool to assess the events around a death. Applying an audit cycle can highlight breakdowns from local to national levels and ultimately improve civil registration and vital statistic (CRVS) systems and quality of care. Maternal death surveillance and response (MDSR) is a form of this strategy that has been used by many countries.
Less information, however, has been captured and assessed on stillbirths and neonatal deaths. In 2014, 51 priority countries reported having a policy on maternal death notification, and only 17 countries had a policy for reporting and reviewing stillbirths and neonatal deaths.
We asked six experts from Malaysia, Ireland, Ethiopia and India about the importance of multi-disciplinary teams in maternal death surveillance and response (MDSR) systems. Here are the insights they shared with us.
Our contributors have all worked closely with MDSR (or maternal death review also known as MDR, which is a component of MDSR) in various guises, contexts and parts of the world. We have drawn together common themes from their insights to draw out lessons learned for the successful implementation of multi-disciplinary health actor involvement in MDSR.