Building a stronger ‘Response’ through learning and collaboration

Maternal and Perinatal Death Surveillance and Response (MPDSR) is a fundamental strategy in preventing maternal and perinatal deaths and has reached 105 hospitals across 27 districts (out of 77) in Nepal. The Family Welfare Division indicated the majority of maternal deaths occured in hospitals, emphasizing the need for strengthening hospital-based MPDSR systems. Hence, under the leadership of FWD and health directorate of Koshi province, USAID's Momentum Country and Global Leadership (MCGL) initiated virtual training for service providers and managers in MPDSR, amidst the COVID pandemic. During the learning meeting, the 'response' component of the MPDSR approach was identified as a weak link, largely due to unaddressed 'delays 1 and 2'.

MCGL proposed strengthening the 'response' component through the introduction of an MPDSR scorecard for monitoring and follow-up of response plans, developing MPDSR mentors, and active government involvement. A series of workshops employing the Behaviorally Focused Applied Political Economic Analysis (BF-APEA) approach were also held to identify feasible strategies for bolstering MPDSR. MCGL then supported the execution of the action plans developed during these meetings.

Key outcomes included the endorsement and digitalization of the MPDSR scorecard, the establishment of recurring monthly meetings, commitments from health offices to provide support for MPDSR implementation, and improvements in implementation status of hospital MPDSR from baseline to midline. MCGL integrated data review and learning meetings as CLA approaches, leading to a comprehensive system for MPDSR strengthening. Although it's early to assess outcomes fully, the collaborative efforts are beneficial in implementing the response plans and seem promising in reducing maternal and perinatal deaths in the province.