Accountability Beyond Blame: Rethinking Maternal Death Surveillance and Response

Maternal death reviews or audits are among several interventions used to reduce maternal mortality. The maternal death surveillance and response (MDSR) system is one such mechanism, combining case identification with analysis of underlying causes to inform corrective action. Although introduced to generate information for accountability in maternal health, the meaning and implications of accountability in this context remain underexamined. A dominant framing of MDSR as an internal quality assurance tool-coupled with a narrow, punitive conception of accountability-appears to limit its potential to help address preventable maternal deaths. This paper draws on the stated objectives and structural design of MDSR to argue that reconceptualizing it as a mechanism of human rights accountability not only aligns with its normative aims but also provides a more robust framework for tackling maternal mortality. It responds to the challenge of achieving accountability without reducing it to blame, examining how MDSR can foster accountability consistent with international human rights standards and what this would entail in practice.