Maternal Death Surveillance and Response

Key points

A Maternal Death Surveillance and Response (MDSR) system collects and analyzes data on individual maternal deaths. Recommendations can then be followed to improve maternity care systems and prevent future maternal deaths. MDSR is used in many low- and middle-income countries to reduce maternal deaths.

image contains four purple blocks with a woman depicted in each

Investigating and reducing maternal deaths

A Maternal Death Surveillance and Response (MDSR) system is a continuous cycle intended to prevent future maternal deaths by learning from previous deaths. This is done by identifying and studying each death, then developing and following recommendations to prevent future deaths from similar causes.

MDSR is especially helpful in countries where official data systems may not record many of the births and deaths and where the risk of maternal death is high.

The Maternal Death Surveillance and Response cycle is shown as a circle that starts blue (surveillance actions) and progresses to yellow (response actions). The MDSR cycle begins with an individual maternal death and progresses through steps of reporting (image of an individual health facility staff member and report forms) and collecting information on the death (image of 3 staff members and clipboard). The cycle continues with committees reviewing information on maternal deaths and making recommendations to prevent maternal deaths (images of committees of 3 health staff and of a building representing the health system), up to the national level where all deaths and recommendations are tracked (image of a health information staff member and a bar chart).
The MDSR cycle begins with a maternal death and progresses through steps of reporting and collecting information on the death.

The steps in MDSR include the following:

  • The cycle begins with health workers identifying a maternal death (death due to pregnancy-related causes).
  • The health workers report (or "notify") that death through the MDSR system.
  • More detailed information on the death is collected by health workers and using a verbal autopsy.
  • The health facility's Maternal Death Review Committee meets to review the information on the death and determine the likely cause of death.
  • A higher-level Maternal Death Review Committee meets periodically to review all the maternal deaths in the area and make recommendations to prevent future maternal deaths from those causes.
  • The health system enacts those recommendations.
  • A higher level (for example, national) entity reviews the MDSR reports, recommendations, and data to monitor the effect of the response to prevent future deaths.

Using MDSR to improve maternal health programs

CDC has worked with Ministries of Health and local health staff to adopt or improve MDSR systems, and to adapt them to the local conditions and needs. This collaborative work has been focused in the following areas:

Working in new areas of MDSR

Improving MDSR data accuracy and analysis for better understanding and decision-making

  • Improving the identification and reporting of deaths, resulting in more accurate data on the number and causes of maternal deaths.
  • Analyzing and interpreting MDSR data to identify and enact facility-based actions to reduce maternal deaths.
  • Compiling and analyzing MDSR data to show the effect of program activities on reducing maternal deaths.
  • Mapping locations of maternal deaths using Geographic Information Systems (GIS).

Preparing to implement MDSR

  • Informing national MDSR guidelines in Uganda, Haiti, Cameroon, and Zambia.
  • Training health staff at all levels of the health system to carry out each stage of the MDSR cycle.
  • Developing a checklist to determine MDSR implementation readiness in humanitarian and vulnerable settings, such as refugee camps, in collaboration with the United Nations Population Fund and the WHO.

Resources

CDC has collaborated with WHO and other global partners to develop and strengthen MDSR guidance and tools, including the following:

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Content Source:
National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP); Division of Reproductive Health