Death notification under the Maternal and Perinatal Death Review (MPDR) system monitors mothers during pregnancy, through childbirth and up to 42 days following delivery and neonates including still births.
Red=maternal death, Blue=still born, Yellow=neonatal death
Death mapping in maternal and perinatal deaths is an innovation of CIPRB and a useful tool for maternal and neonatal health improvements. Death notification is a function utilizing opportunities within the existing health system, extending collaborations between GOs, NGOs and local communities including volunteers to notify deaths.
During implementing MPDR death notification, the district / upazila map was plotted with multicolour dots showing the location of the deceased mothers (red), neonates (yellow) and still births (blue). The death notification indicates the incidence and distribution by geographic and administrative location within the district, providing the district health / family planning managers with an understanding of the maternal and neonatal health situation in the area.
Areas with a high incidence of deaths formed the evidence for review meetings by the health & family planning managers to plan specific remedial action plan to implement and motivate MPDR as priority. Death mapping within MPDR also helps influence policymakers at a national level to understand the magnitude of mortality in remote or hard to reach areas where people are still underprivileged.
An excellent example of the death mapping innovation of CIPRB using MPDR death notification data in policy changeleading to the improvement of maternal and neonatal heath is Kashipur in the Thakurgaon district. By mapping deaths plotted with multi color dots, Kashipur was highlighted in 2010 as an area with a high incidence rate of maternal, neonatal deaths and still births. A total of 39 deaths were notified, 4 were maternal deaths, 20 neonatal and 15 still births.
This information was shown at the national level MPDR sharing meeting on 1st Nov 2010. The Line director ESD, DGHS requested the local authority to act immediately. Actions were undertaken by Community Clinic in Kashipur with the deployment of a trained community skilled birth attendant, who provided MNH services. 200 Normal vaginal deliveries took place between 2011 and 2013, with about 20-30 mothers receiving antennal care each month.
The community also provided strong support for the initiative. One of the villagers in response donated a piece of land to expand the Community Clinic building. The authority renovated the CC into a 10 bed hospital in 2012. The MPDR data changed the paradigm; in 2012 no maternal deaths occurred in this union. After initiating the service for mothers and new-born babies, Kasipur is now an evidenced based example for reducing maternal and neonatal mortality,