Implementing Maternal Death Surveillance and Response in Kenya: Incremental Progress and Lessons Learned

Area of Science:

• Public Health
• Reproductive Health
• Healthcare Quality Improvement

Background:

• Maternal death surveillance and response (MDSR) is crucial for identifying causes of maternal mortality and informing interventions.
• Effective MDSR requires coordinated national and district-level stakeholder engagement in a non-punitive environment.
• Kenya's experience provides insights into implementing MDSR in a real-world setting.

Purpose of the Study:

• To summarize experiences and challenges in implementing MDSR in Kenya.
• To identify successes and areas for improvement in Kenya's MDSR system.
• To inform strategies for enhancing maternal and neonatal mortality reduction efforts.

Main Methods:

• A field action report detailing the implementation of MDSR in Kenya.
• Summary of experiences from maternal death assessors and Ministry of Health representatives.
• Analysis of challenges encountered during MDSR implementation.

Main Results:

• Strong national leadership through a coordinating secretariat was effective.
• Key challenges included underreporting, data review difficulties, and suboptimal cause-of-death aggregation.
• Perinatal death surveillance and response is planned as a subsequent phase.

Conclusions:

• Improving maternal death notification and strengthening community-facility linkages are recommended.
• Regular audits and feedback loops are essential for continuous quality improvement.
• Sustained success requires a top-down and bottom-up approach, long-term funding, a legal framework, and improved subnational processes.