Maternal death surveillance and response: technical guidance

Overview

The birth of a baby should be a joyous end to a pregnancy for the mother and her family. Yet the physiological function of reproduction carries with it a number of possible outcomes including grave risks of death and disability for the mother and her baby, particularly in low and middle income countries. There have been significant reductions in maternal and newborn mortality over the last two decades.

Yet in 2010, still there were approximately 287 000 maternal deaths, 2.6 million stillbirths and neonatal deaths, resulting mostly from complications during and following pregnancy and childbirth. Effective interventions to prevent and treat maternal and perinatal complications are well known. Most maternal and perinatal deaths are preventable if life-saving preventive and therapeutic interventions are provided at the right time – in fact, what are known as the “three delays” are major barriers to improving chances of survival:
1) delay in recognizing and seek care when complications occur, 2) delay in reaching a health facility, and 3) delays in receiving appropriate care within the health facility. Recognition of such important links between development and women’s health in particular led to “Improving maternal health” being set as one of the Millennium Development Goals.

To understand how well we are progressing, however, accurate information on how many women died, where they died and why they died is essential, yet currently inadequate. In the absence of reliable vital registration data, maternal mortality estimates are based on statistical models. While statistical estimates increase global awareness of the problem, they do not provide information needed for targeted and timely response. The Commission on Information and Accountability (the Commission), created to track progress on resources and results towards the goals of the UN Secretary-General’s Global Strategy on Women’s and Children’s Health, recommended in its report attention to three interconnected processes – monitoring, reviewing and acting – aimed at learning and continuous improvement in life-saving interventions.

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