Tackling Maternal Mortality in India – Maternal death Surveillance and Response

Pregnancy and childbirth are physiological process which requires supportive supervision. 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 untoward outcomes including grave risks of death and disability for the mother and her baby, particularly in countries like India. Maternal mortality Rate in India is 130/ 1,00,000 live births in 2016-17.

There have been significant reductions in maternal and newborn mortality over the last three decades. 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 the improvement of maternal health being set as one of the Millennium Development Goals.

Trying to understand why a mother died during pregnancy or childbirth, or even weeks later, can be incredibly frustrating. The medical causes may be known, but the full explanation for death from a treatable condition during pregnancy remains unclear. Care may have been available in the woman’s community or in a nearby health facility, but still she dies. Maternal death surveillance and response (MDSR), a relatively new concept that builds on the principles of public health surveillance, supports the processes. MDSR is a form of continuous surveillance that links the health information system and quality improvement processes from local to national levels, which includes the routine identification, notification, quantification and determination of causes and avoidability of all maternal deaths, as well as the use of this information to respond with actions that will prevent future deaths. It links health information system and quality improvement processes from local to national level. It helps in quantification and determination of causes and avoidability of maternal deaths. Each one of these untimely fatalities provides valuable information, which if acted on, can prevent future deaths. In that regard, MDSR emphasizes the link between information and response. MDSR will contribute to strengthening vital registration and better counting of maternal deaths, and provide better information for action and monitoring improvements in maternal health.

The primary goal of MDSR is to eliminate preventable maternal mortality by obtaining and strategically using information to guide public health actions and monitoring their impact. The overall objectives of MDSR are to provide information that effectively guides immediate as well as long term actions to reduce maternal mortality; and assessment of the true magnitude of maternal mortality and the impact of actions to reduce it.

MDSR holds the promise of serving as an efficient intervention to savewomen’s lives. Data on the causes of women’s deaths is the black box ofmaternal mortality. Only with that box in their hands can countries respondeffectively to eliminate preventable maternal deaths.Understanding exactly why a woman died in pregnancy or around the time of childbirthis a crucial first step towards preventing other women dying in the same way. As well asidentifying the medical causes of death, it is important to know the woman’s personalstory and the precise circumstances of her death. There is also inclusion of Maternal Near Miss Reviews to enhance the action taken for prevention of maternal deaths.