Maternal and Perinatal Death Surveillance and Response (MPDSR) Systems in Asia Pacific during the Covid-19 Pandemic 2020-2021

The coronavirus disease 2019 (COVID-19) pandemic has significantly disrupted health services throughout the world, especially for maternal and newborn health. The Maternal and Perinatal Death Surveillance and Response (MPDSR) system is a key initiative to improve the quality of care for maternal and neonatal health and end preventable maternal and newborn deaths. 

Objective

The aim of this project is to understand if disruptions to MPDSR systems and processes had occurred during 2020–2021 in comparison with previous years’ reporting. The findings, along with emerging evidence on the effects of the COVID-19 pandemic on maternal and newborn health outcomes, provide a current picture of where challenges lie and where interventions need to be focused. 

Timeline

2021–ongoing.

Approach

In 2021 we undertook a rapid stocktake process in 22 countries in the Asia Pacific region to understand the impact of COVID-19 on service provision and MPDSR systems.

Data were collected by survey utilising a Likert scale measuring respondents’ agreement with statements regarding MPDSR practices and service disruptions.

Recommendations from the survey include:

• urgent investments are needed to strengthen and scale up subnational and national MPDSR processes to ensure systems are resilient and will be minimally affected by disruptive events such as natural disasters, humanitarian crises, disease outbreaks or pandemics
• investments are needed to strengthen national health management information systems and online reporting systems, to include MPDSR data to improve the timely availability of information about all maternal and perinatal deaths from both facility and community levels
• focus investments on improving MPDSR reporting, investigation, assigning cause of death and response when deaths occur in the community, including improving verbal autopsy implementation and, if required, addressing the current culture of blame, which decreases death reporting
• invest in MPDSR capacity at provincial/capital level to support complete MPDSR framework implementation
• consider codifying the establishment of a comprehensive MPDSR system in a national legal or policy framework in alignment with international, regional and national public health and human rights standards. 

In 2022–2023 we undertook a situational analysis in each of 6 high burden countries (Bangladesh, Cambodia, Lao PDR, Timor- Leste, Nepal, Papua New Guinea) to overview and analyse the status of implementation and challenges for the MPDSR system; to identify areas of strength as well as areas for improvement; and prepare an evidence-based MPDSR improvement plan in collaboration with national authorities, local MPDSR stakeholders as well as international technical partners.

The system review and improvement plan were the result of an in-depth quantitative and qualitative review of the MPDSR system, including policy and guidelines review, interviews with stakeholders and service providers, and data review and quantitative analysis. 

Community impact

The findings of the project will identify a key pathway for system improvement in 2023, which will lead to an improved identification, review and analysis of maternal and perinatal deaths, as well as a strengthened focus on identifying corrective actions for each death, to avoid similar preventable deaths happening in future.