A maternal and perinatal death reviews (MPDR) system has been embedded in Mara Region in Tanzania with support from the Mama Ye-E4A programme. This programme worked with the Ministry of Health to establish accountability mechanisms at and council levels in line with the national MPDR guidelines which ensures timely reviews of the implementation progress. The evidence-based National MPDR Guidelines have been replaced by MPDSR guidelines.
Mara was chosen by the Ministry of Health to act as an initial roll-out region for the new MPDSR guidelines in Tanzania. A subsequent assessment suggests that health care providers and managers have the required skills to implement the national guidelines effectively across all levels of service delivery and administration. This brings optimism that for the first time in the national implementation of maternal and perinatal death audits, progress will be monitored and evaluated to inform subsequent responses in maternal and perinatal survival and well-being for transformative gains across the health sector and beyond.
In embedding a functioning action and response cycle through the MPDSR process, Mama Ye-E4A ensured that decision-makers have been supported to continue to deliver against their responsibilities and commitments such that a functioning action and response cycle is embedded and sustainable in Mara region. The last quarter saw the end of the Mama Ye-E4A programme in Tanzania, but the important progress and championing of the establishment and subsequent roll-out of MPDSR looks set to continue under the remit of the GIZ-supported Tanzania German Health Support Programme.
The MPDSR system has been rolled out by the Ministry of Health to two more regions of Kagera and Lindi. Already, training has been conducted for key personnel in all hospitals in the two regions, regional and council health management team members and to stakeholders’ staffs supporting the two regions in RMNCAH namely Jhpiego and GIZ respectively. MPDSRs are recognised as key accountability and quality of care improvement mechanisms and referred to in the National Health Sector Strategic Plan 2016-2020- an important health sector guiding document beyond RMNCAH to ensure they remain a priority in the years to come. They have also been incorporated in the final drafts of the One Plan II (National RMNCAH Strategy for 2016-2020).
At the national level, the WHO country office has released funds for rolling out MPDSR across all regions in the country using the same platform that was used to roll-out the Sharpened National Accelerated Plan for Reduction of Maternal, Newborn and Child Deaths. Thus, significant activities are expected countrywide with a focus to impact appropriate skills in MPDSR implementation across all regions.
This update was informed by feedback from Moke Magoma, former Evidence Advisor on Mama Ye-E4A Tanzania; a March 2016 policy study conducted by Dr Sarah Clark (University College London), Dr Stephanie Smith (University of New Mexico), and Dr Moritz Hunsmann (French National Centre for Scientific Research); country director reports; and Mama Ye-E4A quarterly reports.