Findings from a Qualitative Survey in the Asia-Pacific Region on Maternal and Perinatal Death Surveillance and Response (MPDSR) and Maternal Health Service Disruptions During the COVID-19 Pandemic 2020–2021

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      The global maternal mortality ratio (MMR) decreased by approximately 38% in two decades with reductions accelerating prior to 2020. The COVID-19 pandemic has caused major health system interruptions, and the direct and indirect consequences of this has worsened maternal and neonatal outcomes.
      The Maternal and Perinatal Death Surveillance and Response (MPDSR) system, used in countries with a high maternal mortality burden, and the “Near Miss” system, for countries such as Australia with very low maternal mortality, have been identified by the World Health Organisation (WHO) as essential interventions to mitigate against the indirect effects of COVID-19 on maternal and perinatal outcomes.
      We undertook a rapid stocktake process to understand the impact of COVID-19 on service provision and MPDSR in the Asia Pacific Region, where the majority of countries experience high maternal mortality. Data were collected by survey of 22 countries utilising a Likert scale measuring respondents’ agreement with statements regarding MPDSR practices and health service disruptions.
      Most frequently reported disruptions to MPDSR systems were lack of completion or delay of death reviews at both facility and country level and decreases in number of community death notifications. Redeployment of both midwives and those responsible for MPDSR activities was identified as key issues. Other Covid-19 related service disruptions included reduced attendance at facilities for birthing, shortages of life-saving drugs, reduced operating theatre availability, and difficulty accessing emergency transport.
      Alongside evidence from other epidemics and emerging evidence about the global impact of the COVID-19 pandemic on maternal and newborn outcomes, the survey results indicate continued disruptions to essential maternal and newborn services. Midwives working together as part of a team and supported to provide clinical care and roles in health improvement systems such as MPDSR, have the capacity to ensure the gains made in tackling maternal and perinatal death will not be undone.