LUCKNOW: As many as 36 women die in the process of childbirth in UP every day. These deaths add up to over 13,200 in a year, which is 30% of 44,000 maternal deaths that take place in India every year.
However, health authorities may not be able to tell the exact cause of these deaths as close to 50% cases are not even reported under the health management information systems. The two problems, which find mention in Union health ministry’s ‘Guidelines for Maternal Death Surveillance and Response’, speak for the gaps in maternal death monitoring system.

As per WHO, maternal death refers to the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.

The Indian government started the Maternal Death Review (MDR) process in 2010 to improve quality of obstetric care and reduce maternal mortality and morbidity.

MDR provides detailed analysis on various factors at community, facility, district, regional and national level.

The introductory note in the guidelines, however, pointed out that though the system was implemented in different states in the last five years, the ‘mechanism for response’ lagged behind. In fact, three main problems were identified.

Firstly, less than 50% of estimated maternal deaths in India get reported under the health management information systems. Secondly, capacity to undertake quality review at various levels is weak. Thirdly, there was a problem in translating the key findings into action.

Based on the past learnings and feedback, the Union health ministry streamlined the process of Maternal Death Surveillance and Response (MDSR). The guidelines framed focus on ‘improving reporting of maternal deaths’ and ‘improving analysis and action planning’.

” MDSR is a continuous cycle of identification, notification and review of maternal deaths followed by actions to improve quality of care and prevent future deaths,” said Prashant Trivedi, principal secretary, health and family welfare. He added that the relevant committees to implement MDSR have been formed by the state government.