Health System Readiness to Manage Maternal Death Data and Avail Evidence for Decision-Making Through Maternal Death Surveillance System in Ethiopia, 2020

Abstract

Abstract Background: - Maternal mortality remains a major health problem in Ethiopia. To generate contextual evidence, Maternal Death Surveillance and Response system was introduced in 2013. This assessment is conducted to describe the health system's readiness to avail evidence for decision-making through MDSR system in Ethiopia. Method: - Cross-sectional study designed using the modified WHO framework for evaluating disease surveillance systems was used. Using a multistage sampling, 631 health facilities and 539 health posts were selected. Pretested survey questionnaires designed using ODK software were used. Trained field epidemiology residents were used for data collection from September 2019 to April 2020. Text descriptions, graphs, maps, and tables were used to present the study findings. Findings: - Final study finding shows that 400 (77.1 percent) health facilities and 264 (71.5 percent) health posts claimed that they are implementing the MDSR system. Of the total implementing health facilities, 349 (87.3 percent) of them have a death review committee, and only 42 (12.4 %) were functional. About 89.4% of health centers and 79.4% of hospitals had sub-optimal readiness for maternal death identification and notification. Among implementing health posts, 39 (14%) and 231 (87.5%), of them had locally translated community case definitions and established mechanisms for receiving death reports from the community. Only 23 (6.96 percent) and 18 (26.47 percent) MDSR implementing health centers and hospitals had optimal readiness to investigate and review maternal deaths. Additionally, surveillance officers and HEWs at 6 (1.5 percent) and 24 (9.1 percent) systems implementing health facilities and health posts were engaged in data analysis and evidence generation at least once during 2019/20. Conclusions and Recommendations: - Sub-optimal MDSR system implementation is registered. Revitalizing the system by addressing all system components is critical. Having a national-level roadmap for MDSR system implementation and mobilizing all available resources and stakeholders to facilitate this is vital. It is also critical to establish a system for routine data quality monitoring and assurance integrated with the existing PHEM structure. Having a system for routine capacity building, advocacy, and monitoring and evaluation of the availability and functionality of MDSR committees at health facilities are all critical.