Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Research Article Volume 5 Issue 12

Implementing Maternal Death Surveillance and Response System: Lessons Learned from the Arab States Region

Mohammed Lardi1*, Bouchra Assarag2, Halima Mouniri1, Radouane Belouali3, Mohamed Afifi4, Mansour Njah5, Hala Bawadi6 and Shible Sahbani4

1International Freelance, Public Health Specialist, Morocco

2National School of Public Health, Ministry of Health, Morocco

3International School of Public Health, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco

4United Nations Population Fund, Arab States Regional Office, UNFPA, ASRO

5International Freelance Consultant, Tunisia

6MCH Nursing Department, The University of Jordan, Jordan

*Corresponding Author: Mohammed Lardi, International Freelance, Public Health Specialist, Morocco.

Received: September 04, 2021; ; Published: November 26, 2021

Abstract

Context: For many years, MDSR has been implemented in many countries including Arab States Region. The literature review shows that interventions are poorly documented in the Arab States Region. Our objective is to assess the implementation of the MDSR in 5 Arab States Region and point out the challenges faced in order to disseminate good practices and come up with a set of recommendations toward improving the MDSR systems in the all Arab States Region.

Method: The analysis was conducted in five countries: Egypt, Sudan, Jordan, Tunisia, and Morocco. In line with the World Health Organization’s guidelines and tools, the research team explored four essential components: (i) Maternal health status in the country (ii) MDSR policy and strategy (iii) MDSR governance, mainly stakeholder participation and legislation, and (iv) MDSR process. Each country team has developed a preliminary report that was first validated by the country team then shared with the regional research team who developed a regional report summarizing MDSR in these countries. National and regional reports were presented in a regional expert group meeting and validated by the technical committee. In this research, the evaluation methodology adopted is based on three dimensions: First, an analysis of maternal mortality context and maternal health in the country as well as analysis of demographic and health system context. Then a quantitative and qualitative analysis of the process MDSR was conducted. Finally, case studies were reported from each country.

Results: The findings showed that MDSR has been widely implemented but with varying degrees of political commitment, allocated resources, governance and processes. an under-reporting of deaths due to a) low commitment of health professionals, decision makers and university hospitals, b) limited coverage of civil registration and vital statistics (CRVS) [1] among the rural population and c) reluctance of the private sector to share data. In addition, maternal deaths notified through MDSR systems are higher than those provided by the routine health management information system. For all countries, notified cases are not all reviewed and financial constraints represent a real threat for ensuring regular meetings of review committees and developing and producing MDSR reports. No country has a clear dissemination strategy to allow a timely use of data and evidence-based decision-making. In some countries, the recommendations are translated into an action plan. Very often, they do not allow regular monitoring as they are not time-bound and there are no clear indicators set ahead to measure change.

Conclusion: Although MDSR has been widely implemented there is still a need for a concrete high-level operational commitment that sets the foundations for the legislative and legal framework. MDSR is a complex health system strengthening process that needs to be enhanced and linked to an improved civil registration and vital statistics (CRVS) system. Also, there is a gap between surveillance and response components that calls especially for prompt and strong decision based on the evidence generated by the MDSR system.

 

Keywords: Maternal Mortality; Maternal Death Surveillance and Response; Civil Registration and Vital Statistics; Arab States Region

References

  1. WHO, Regional Office for the Eastern Mediterranean. "Monitoring health and health system performance in the Eastern Mediterranean Region: core indicators and indicators on the health-related Sustainable Development Goals (2019)?” World Health Organization? Regional Office for the Eastern Mediterranean (2019).
  2. MOH SUDAN. "National RMNCAH Strategy 2016-2020 in Sudan" (2016).
  3. MOH Morocco. "Plan National 2008-2012 pour l’Accélération de la Réduction de la Mortalité Maternelle et Infantile”. Etat d’avancement (2012).
  4. MOH Sudan. "Maternal death surveillance and response in Sudan" (2014).
  5. MOH Tunisia. "Etat des Lieux de la SMNN en Tunisie". DSSB (2015).
  6. "Regional strategy for the improvement of civil registration and vital statistics system 2014-2019?” (2014).
  7. " State of the world, Unfinished business" (2019).
  8. MOH and Morocco. "Enquête Nationale sur la Population et la Santé Familiale EPSF” (2018).
  9. "Beyond the numbers: reviewing maternal deaths and complications to make, pregnancy safer?” (2004).
  10. "Time to respond: a report on the global implementation of maternal death surveillance and response?” (2016).
  11. RJ Ravichandran J. "Lessons from the confidential enquiry into maternal deaths, Malaysia". British Journal of Obstetrics and Gynaecology 4 (2014): 47-52.
  12. Achem FFCO and Agboghoroma. "Setting up facility-based death reviews in Nigeria". British Journal of Obstetrics and GynaecologyS4 (2014): 75-80.
  13. HSD Bernis., et al. “Towards elimination of maternal deaths: maternal deaths surveillance and response". Reproductive health1 (2013): 1.
  14. M Koblinsky. "Maternal Death Surveillance and Response: A Tall Order for Effectiveness in Resource-Poor Settings" (2017).
  15. WHO, " Maternal death surveillance and response: Technical guidance information for action to prevent maternal deaths" (2013).
  16. "Maternal death surveillance and response: technical guidance information for action to prevent maternal death" (2013).
  17. International school of public health; University Mohammed VI; Casablanca; Morocco, "Availability of data and materials the case studies upon which this study is based are publicly available at International school of public health, University Mohammed VI, Moro". International School of Public Health; Mohammed VI University of Health Sciences (UM6SS); Casablanca; Morocco (2017).
  18. MOH Sudan. "MICS survey report”. Sudan (2104).
  19. MOH Egypt. "Egypt Demographic and Health Survey (EDHS)" (2014).
  20. J MOH. "Department of Statistics (DOS). Jordan statistical Yearbook. The Hashemite of Jordan” 67 (2016).
  21. MOH and Morocco. "Rapports sur la surveillance des décès maternels et réponse, (MS, 2010, 2013, 2015)" (2013).
  22. MOH Sudan. "NMDSR reports 2010, 2011, 2012, 2013, 2014, 2015, 2016, sudan" (2016).
  23. , et al. "Maternal Death Surveillance and Response Systems in driving accountability and influencing change". International Journal of Gynecology and Obstetrics 135.5 (2016): 367-371.
  24. A Saloua., et al. “Preventable maternal mortality in Morocco: the role of hospitals". Tropical Medicine and International Health 4 (2013): 444-450.
  25. Kurinczuk D., et al. “Mothers and babies: reducing risk through audit and confidential enquiries across the UK ". British Journal of Obstetrics and Gynaecology (2014).
  26. "Improvement of civil registration and vital statistics". Regional Office for the Eastern Mediterranean CRVS (2019).
  27. MT UNFPA. "États des milieux de la santé maternelle et néonatale en Tunisie”. 2ème edition (2017).
  28. T MOH. "Objectifs du millénaire pour le développement: réalisation et disparités régionales en Tunisie”. NEW MEDIT (2011).
  29. République Tunisienne. "Rapport national sur la population et le développement, le caire + 20" (2013).
  30. JD MOH. “1990-2012 Jordan Population and Family Health Surveys". Trends in Demographic and Health Indicators in Jordan (2012).
  31. "State of the world". unfinished business (2019).
  32. E Mansour and K Nasr. "Report Review of Egyptian MMSS at MCH-MOHP" (2016).
  33. HCP Morocco "Recensement Morocco". (2014).
  34. MOH and Tunisia. Meeting under the theme: “Maternal Mortality. For how long?” Tunis declaration On Maternal Newborn and Child Health, 20. no. Campaign for the Accelerated Reduction of Maternal Mortality in Africa (CARMMA, (2011).
  35. Tunisia “Rapport sur le développement humain" (2016).
  36. Office National de la Famille et de la Population; Tunisia, Enquête Nationale sur la Mortalité Maternelle en Tunisie 2009-2010 (2010).
  37. , et al. "The confidential enquiry into maternal deaths in South Africa: a case study". British Journal of Obstetrics and Gynaecology 4 (2014): 53-60.

Citation

Citation: Mohammed Lardi., et al. “Implementing Maternal Death Surveillance and Response System: Lessons Learned from the Arab States Region". Acta Scientific Medical Sciences 5.12 (2021): 166-178.

Copyright

Copyright: © 2021 Mohammed Lardi., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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