Port Louis: Mauritius is highly committed to mobilize all available means and resources to achieve zero maternal, neonatal and perinatal deaths. One of these means is the institutionalization of a rigorous Maternal and Perinatal Death Surveillance and Response system (MPDSR) with the support of the World Health Organization (WHO).  The very first step was to build capacity of health workers over a five-day training on MPDSR during the second week of October 2023.

WHO recommends countries to establish the maternal and perinatal death surveillance and response (MPDSR), an essential quality improvement intervention enabling identification, notification, quantification and determination of the causes and factors leading to maternal and neonatal deaths and stillbirth. Obtaining and using information on each maternal and perinatal death enables evidence based decision making on the necessary public health actions and measures to eliminate preventable maternal and perinatal deaths and to monitor these measures’  effectiveness and impact.

The training participants comprised Director Health Services, Maternal Child Heath; Specialist and Consultant in Charge Gynecology and Obstetrics; Specialist and Consultant in Charge Pediatrics; Medical Superintendents, Medical Health Officers, Chief Health Records Officers, Statistician, Sexual and Reproductive Health Coordinator; Nursing Officers and Midwifes working in the Labour, Postnatal Nursery, Neonatal Intensive Care unit wards; representatives from private clinics and academia.

These trainees from multi-disciplinary background eagerly learned the principles, approaches and impact of MPDSR and new techniques to conduct confidential inquiries, maternal and perinatal death reviews and the steps towards setting up an effective maternal and perinatal death surveillance and response system.  The contributing positive and negative factors of Maternal Near Miss cases were also addressed during the training.  Engaging the national stakeholders including professional associations, the private sector on MPDSR added value to the discussions during group work.

The Minister of Health and Wellness, Dr the Hon. Kailesh Kumar Singh Jagutpal, underlined the important role and responsibility of the health care providers in ensuring every woman and newborn receive the best possible care.  He also highlighted the need for the country to establish an effective MPDSR system to monitor, analyse and response to preventable deaths of women in the reproductive age and their newborn.  

Dr Anne Ancia, the WHO Representative in Mauritius emphasized on the five main causes of maternal mortality: severe bleeding during and after delivery, complications during abortion, hypertensive disorders during pregnancy, infections especially post-partum, and obstructed labour.  She added, “most of the causes of maternal and perinatal deaths are preventable.  Appropriate and timely actions can help to reduce them.

“There has been a slight increase in maternal mortality rate from 57 deaths per 100,000 live births to 84 deaths per 100,000 live births in 2020 in Mauritius”, said Dr A. Ancia.  She added, “this training on MPDSR will help the country to reverse this increasing trend by enabling the formulation of informed decisions and policies”.

At the end of the training, participants expressed their satisfaction on the methodology and approaches used by the facilitators from the WHO Regional Office for Africa to make learning and knowledge sharing easy, participatory and engaging. Emphasis was constantly laid on the “no blame, no shame” fostering mechanism shifting the blame-centric approach to a more constructive change of mindset for successful MPDSR implementation. It was an enriching, insightful experience having both private and public health workers under one roof to discuss important issues around maternal and perinatal deaths.  

This training is however just a starting point towards concrete actions to eliminating preventable maternal and perinatal deaths. An MPDSR committee will soon be set up and the very first step will be for committee members to develop a national roadmap for the establishment and implementation of MPDSR at all levels of the health system.