A Strategy for Reducing Maternal Mortality

Abstract

A confidential system of enquiry into maternal mortality, based on that used in England and Wales, was introduced in Malaysia in 1991 with a view to identifying deficiencies in care and recommending remedial measures.

In public hospitals the system requires a named maternal death coordinator to review every instance of mortality in women aged between 15 and 49 years and to decide whether a maternal death investigation is required; the patient's notes are examined to see if amenorrhoea has occurred. Instances of death at home are reviewed by the community health coordinator in the district concerned; this process includes interviewing family members. The coordinators present their findings to the obstetricians in the hospitals that provided care for the patients or
to the district medical officers. The regional maternal and child health officer, who is initially contacted by telephone and subsequently in writing, passes the information to a regional review committee, which sends a confidential report on the cause of death, areas of substandard care, and necessary remedial actions to the National Technical Committee.