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
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
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)  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
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: © 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.