Current methods for estimating maternal mortality lack precision, and are not suitable for monitoring progress in\r\nthe short run. In addition, national maternal mortality ratios (MMRs) alone do not provide useful information on\r\nwhere the greatest burden of mortality is located, who is concerned, what are the causes, and more importantly\r\nwhat sub-national variations occur. This paper discusses a maternal death surveillance and response (MDSR) system.\r\nMDSR systems are not yet established in most countries and have potential added value for policy making and\r\naccountability and can build on existing efforts to conduct maternal death reviews, verbal autopsies and\r\nconfidential enquiries. Accountability at national and sub-national levels cannot rely on global, regional and national\r\nretrospective estimates periodically generated from academia or United Nations organizations but on routine\r\ncounting, investigation, sub national data analysis, long term investments in vital registration and national health\r\ninformation systems. Establishing effective maternal death surveillance and response will help achieve MDG 5,\r\nimprove quality of maternity care and eliminate maternal mortality (MMR = 30 per 100,000 by 2030).
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