Study on the implementation of maternal death review in five countries in the South-East Asia Region of the World Health Organization
The Maternal mortality ratio universally used to track Millennium Development Goal No. 5 – to reduce maternal mortality and improve material health – is only a quantitative measure and is not sufficient to prevent maternal deaths. To understand the circumstances that lead to, or contribute to these deaths, a maternal death review (MDR) or audits is needed. The world health Organization guide “Beyond the numbers: reviewing material deaths and complications to make pregnancy safer” (2004) describes the methods of the MDR. Countries of the South-East Asia Region have been implementing MDRs using any combination of these methods to verifying extents. This study on the implementation of MDRs was conducted in five countries in the Region, namely India, Indonesia, Myanmar, Nepal and Sri Lanka. Each study was carried out with the same general aim to ascertain the level of MDR implementation (in any form or by any method) in the country, to strengthen the MDR as necessary, and to assist countries in building on their experiences to move towards maternal death surveillance and response. While the MDR was being implemented in each of the five countries, the form it tool and the magnitude of implementation varied. In general, these studies recommend that the respective countries strengthen the management of the current MDR Programme, and address the weaknesses identified, including strategies to raise the awareness of policy-makers and members of the community on the importance of MDR.