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Abebe B, Busza J, Hadush A, et al. 'We identify, discuss, act and promise to prevent similar deaths': a qualitative study of Ethiopia's Maternal Death Surveillance and Response system. BMJ Glob Health. 2017;2(2):e000199doi: 10.1136/bmjgh-2016-000199.
Abebe, B., Busza, J., Hadush, A., Usmael, A., Zeleke, A. B., Sita, S., Hailu, S., & Graham, W. J. (2017). 'We identify, discuss, act and promise to prevent similar deaths': a qualitative study of Ethiopia's Maternal Death Surveillance and Response system. BMJ global health, 2(2), e000199. https://doi.org/10.1136/bmjgh-2016-000199
Abebe, Berhanu, et al. "'We identify, discuss, act and promise to prevent similar deaths': a qualitative study of Ethiopia's Maternal Death Surveillance and Response system." BMJ global health vol. 2,2 (2017): e000199. doi: https://doi.org/10.1136/bmjgh-2016-000199
Abebe B, Busza J, Hadush A, Usmael A, Zeleke AB, Sita S, Hailu S, Graham WJ. 'We identify, discuss, act and promise to prevent similar deaths': a qualitative study of Ethiopia's Maternal Death Surveillance and Response system. BMJ Glob Health. 2017 Mar 14;2(2):e000199. doi: 10.1136/bmjgh-2016-000199. eCollection 2017. PMID: 28589016; PMCID: PMC5435261.
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BMJ Glob Health. 2017 Mar 14;2(2):e000199. doi: 10.1136/bmjgh-2016-000199. eCollection 2017.

'We identify, discuss, act and promise to prevent similar deaths': a qualitative study of Ethiopia's Maternal Death Surveillance and Response system.

BMJ global health

Berhanu Abebe, Joanna Busza, Azmach Hadush, Abdurehman Usmael, Amsalu Belew Zeleke, Sahle Sita, Solomon Hailu, Wendy J Graham

Affiliations

  1. MCH Department, WHO Ethiopia Country Office, Addis Ababa, Ethiopia.
  2. Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK.
  3. IMMPACT, University of Aberdeen, Aberdeen, UK.

PMID: 28589016 PMCID: PMC5435261 DOI: 10.1136/bmjgh-2016-000199

Abstract

INTRODUCTION: Ethiopia introduced national Maternal Death Surveillance and Response (MDSR) in 2013 and is among the first sub-Saharan African countries to capture data on facility-based and community-based maternal deaths. We interviewed frontline MDSR implementers about their experiences of the first 2 years of MDSR, including perceptions of its introduction and outcomes for health services.

METHODS: We conducted a qualitative case study in 4 zones in the largest regions, interviewing 69 key informants from regional, zonal, district and facility levels.

RESULTS: A defining feature of Ethiopia's MDSR system is its integration within existing disease surveillance, with both benefits and challenges. Facilitators of the system's introduction were strong political support, alignment with broader health strategies and strong links across health system departments. Barriers included confusion around new responsibilities, high staff turnover and fear of legal repercussions. Stakeholders believed MDSR increased confidence in using local data to improve maternal health services and enhanced communication across the health system.

CONCLUSIONS: MDSR systems take time to establish, encountering challenges in early implementation. Ensuring MDSR has a clear purpose, explicitly defined roles and responsibilities, and adequate supervisory support from the start will ensure it becomes embedded within the health system as routine practice rather than perceived as a stand-alone system. Countries planning to adopt or extend MDSR can learn from Ethiopia's experience, particularly the decision to make maternal mortality a weekly reportable condition within Public Health Emergency Management.

Conflict of interest statement

Competing interests: All authors worked for the Evidence for Action (E4A) programme at the time of conducting the study and writing the paper, which was funded through the UK Department for Internatio

References

  1. BJOG. 2014 Sep;121 Suppl 4:67-70 - PubMed
  2. J Health Popul Nutr. 2013 Jun;31(2):262-71 - PubMed
  3. Int J Gynaecol Obstet. 2015 Oct;131 Suppl 1:S3-5 - PubMed
  4. BJOG. 2014 Sep;121 Suppl 4:53-60 - PubMed
  5. Reprod Health. 2013 Jan 02;10:1 - PubMed
  6. Lancet. 2013 Jul 13;382(9887):146-57 - PubMed
  7. Bull World Health Organ. 2011 Nov 1;89(11):779-779A - PubMed
  8. Int J Gynaecol Obstet. 2014 Aug;126(2):111-4 - PubMed
  9. BJOG. 2014 Sep;121 Suppl 4:112-6 - PubMed
  10. BJOG. 2014 Sep;121 Suppl 4:75-80 - PubMed
  11. Int J Gynaecol Obstet. 2009 Jul;106(1):89-94 - PubMed
  12. BJOG. 2014 Sep;121 Suppl 4:95-101 - PubMed

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