Maternal Deaths Surveillance and Response System: A Case of Nepal

The objective of this paper is to share Nepali experience of maternal death surveillance and response in reducing preventable maternal deaths. Secondary data, mainly an assessment report of Maternal and Perinatal Death Surveillance and Response system, is used in developing this paper. To bridge the information gap, informal discussions were held with key informants. Reducing maternal mortality is an unfinished agenda of millennium development goals, which is carried over to sustainable development goals era. Nepal, building on an ongoing initiative of Maternal Death Review, established a Maternal and Perinatal Death Surveillance and Response system. It comprises: (a) maternal death review and response in community; and (b) maternal death review and response in hospitals. Until 2019, 11 districts implemented the former component, while 77 hospitals practiced the latter. The main reason underlying maternal death was delay in getting adequate care. Social factors contributed to delay in 89.6% of cases, while in 10.4% of cases, it was attributed to factors in health care. The paper concludes that public health measures and improved service quality was key in preventing maternal deaths. It is, however, imperative to undertake an in-depth review and thereby define interventions for strengthening and upscaling the initiative.