Implementation of maternal and perinatal death surveillance and response (MPDSR) in humanitarian settings: insights and experiences of humanitarian health practitioners and global technical expert meeting attendees
Abstract Background Maternal and perinatal death surveillance and response (MPDSR) is a system of identifying, analysing and learning lessons from such deaths in order to respond and prevent future deaths, and has been recommended by WHO and implemented in many low-and-middle income settings in rece...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | Conflict and Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13031-022-00440-6 |
| _version_ | 1811305856195624960 |
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| author | Neal Russell Hannah Tappis Jean Paul Mwanga Benjamin Black Kusum Thapa Endang Handzel Elaine Scudder Ribka Amsalu Jyoti Reddi Francesca Palestra Allisyn C. Moran |
| author_facet | Neal Russell Hannah Tappis Jean Paul Mwanga Benjamin Black Kusum Thapa Endang Handzel Elaine Scudder Ribka Amsalu Jyoti Reddi Francesca Palestra Allisyn C. Moran |
| author_sort | Neal Russell |
| collection | DOAJ |
| description | Abstract Background Maternal and perinatal death surveillance and response (MPDSR) is a system of identifying, analysing and learning lessons from such deaths in order to respond and prevent future deaths, and has been recommended by WHO and implemented in many low-and-middle income settings in recent years. However, there is limited documentation of experience with MPDSR in humanitarian settings. A meeting on MPDSR in humanitarian settings was convened by WHO, UNICEF, CDC and Save the Children, UNFPA and UNHCR on 17th–18th October 2019, informed by semi-structured interviews with a range of professionals, including expert attendees. Consultation findings Interviewees revealed significant obstacles to full implementation of the MPDSR process in humanitarian settings. Many obstacles were familiar to low resource settings in general but were amplified in the context of a humanitarian crisis, such as overburdened services, disincentives to reporting, accountability gaps, a blame approach, and politicisation of mortality. Factors more unique to humanitarian contexts included concerns about health worker security and moral distress. There are varying levels of institutionalisation and implementation capacity for MPDSR within humanitarian organisations. It is suggested that if poorly implemented, particularly with a punitive or blame approach, MPDSR may be counterproductive. Nevertheless, successes in MPDSR were described whereby the process led to concrete actions to prevent deaths, and where death reviews have led to improved understanding of complex and rectifiable contextual factors leading to deaths in humanitarian settings. Conclusions Despite the challenges, examples exist where the lessons learnt from MPDSR processes have led to improved access and quality of care in humanitarian contexts, including successful advocacy. An adapted approach is required to ensure feasibility, with varying implementation being possible in different phases of crises. There is a need for guidance on MPDSR in humanitarian contexts, and for greater documentation and learning from experiences. |
| first_indexed | 2024-04-13T08:33:57Z |
| format | Article |
| id | doaj.art-ed723c8884bd4fd2be9be91935dbd738 |
| institution | Directory Open Access Journal |
| issn | 1752-1505 |
| language | English |
| last_indexed | 2024-04-13T08:33:57Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Conflict and Health |
| spelling | doaj.art-ed723c8884bd4fd2be9be91935dbd7382022-12-22T02:54:10ZengBMCConflict and Health1752-15052022-05-0116111610.1186/s13031-022-00440-6Implementation of maternal and perinatal death surveillance and response (MPDSR) in humanitarian settings: insights and experiences of humanitarian health practitioners and global technical expert meeting attendeesNeal RussellHannah Tappis0Jean Paul Mwanga1Benjamin Black2Kusum Thapa3Endang Handzel4Elaine Scudder5Ribka Amsalu6Jyoti Reddi7Francesca Palestra8Allisyn C. Moran9JhpiegoHôpital Générale de MwesoMédecins Sans FrontièresJhpiegoCentre for Disease Control and PreventionInternational Rescue CommitteeUniversity of California San FranciscoWorld Health OrganizationWorld Health OrganizationWorld Health OrganizationAbstract Background Maternal and perinatal death surveillance and response (MPDSR) is a system of identifying, analysing and learning lessons from such deaths in order to respond and prevent future deaths, and has been recommended by WHO and implemented in many low-and-middle income settings in recent years. However, there is limited documentation of experience with MPDSR in humanitarian settings. A meeting on MPDSR in humanitarian settings was convened by WHO, UNICEF, CDC and Save the Children, UNFPA and UNHCR on 17th–18th October 2019, informed by semi-structured interviews with a range of professionals, including expert attendees. Consultation findings Interviewees revealed significant obstacles to full implementation of the MPDSR process in humanitarian settings. Many obstacles were familiar to low resource settings in general but were amplified in the context of a humanitarian crisis, such as overburdened services, disincentives to reporting, accountability gaps, a blame approach, and politicisation of mortality. Factors more unique to humanitarian contexts included concerns about health worker security and moral distress. There are varying levels of institutionalisation and implementation capacity for MPDSR within humanitarian organisations. It is suggested that if poorly implemented, particularly with a punitive or blame approach, MPDSR may be counterproductive. Nevertheless, successes in MPDSR were described whereby the process led to concrete actions to prevent deaths, and where death reviews have led to improved understanding of complex and rectifiable contextual factors leading to deaths in humanitarian settings. Conclusions Despite the challenges, examples exist where the lessons learnt from MPDSR processes have led to improved access and quality of care in humanitarian contexts, including successful advocacy. An adapted approach is required to ensure feasibility, with varying implementation being possible in different phases of crises. There is a need for guidance on MPDSR in humanitarian contexts, and for greater documentation and learning from experiences.https://doi.org/10.1186/s13031-022-00440-6HumanitarianMaternalPerinatalMortalitySurveillanceReview |
| spellingShingle | Neal Russell Hannah Tappis Jean Paul Mwanga Benjamin Black Kusum Thapa Endang Handzel Elaine Scudder Ribka Amsalu Jyoti Reddi Francesca Palestra Allisyn C. Moran Implementation of maternal and perinatal death surveillance and response (MPDSR) in humanitarian settings: insights and experiences of humanitarian health practitioners and global technical expert meeting attendees Conflict and Health Humanitarian Maternal Perinatal Mortality Surveillance Review |
| title | Implementation of maternal and perinatal death surveillance and response (MPDSR) in humanitarian settings: insights and experiences of humanitarian health practitioners and global technical expert meeting attendees |
| title_full | Implementation of maternal and perinatal death surveillance and response (MPDSR) in humanitarian settings: insights and experiences of humanitarian health practitioners and global technical expert meeting attendees |
| title_fullStr | Implementation of maternal and perinatal death surveillance and response (MPDSR) in humanitarian settings: insights and experiences of humanitarian health practitioners and global technical expert meeting attendees |
| title_full_unstemmed | Implementation of maternal and perinatal death surveillance and response (MPDSR) in humanitarian settings: insights and experiences of humanitarian health practitioners and global technical expert meeting attendees |
| title_short | Implementation of maternal and perinatal death surveillance and response (MPDSR) in humanitarian settings: insights and experiences of humanitarian health practitioners and global technical expert meeting attendees |
| title_sort | implementation of maternal and perinatal death surveillance and response mpdsr in humanitarian settings insights and experiences of humanitarian health practitioners and global technical expert meeting attendees |
| topic | Humanitarian Maternal Perinatal Mortality Surveillance Review |
| url | https://doi.org/10.1186/s13031-022-00440-6 |
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