A Decade of the Journey of MPDSR Implementation in Bangladesh: Best Practices And Innovations

Background The implementation of Maternal and Perinatal Death Surveillance and Response (MPDSR) in Bangladesh has evolved significantly since its inception in 2010. This study reviews the best practices in MPDSR, focusing on its process, implementation, scale-up, and innovations over a decade of implementation. Methods The study also conducted a comprehensive review of government national MPDSR reports from 2019 to 2024. Additionally, national MPDSR guidelines, avialble published literatures on MPDSR in Bangladesh, government reports, and meeting minutes were examined. Results MPDSR system in Bangladesh began as a pilot project in one district and expanded gradullay to cover all 64 districts by 2024. Initially focusing on maternal and neonatal deaths, MPDSR later incorporated stillbirths into its scope of works. Over the study period from 2019 to 2024, MPDSR reported 2927 maternal deaths and 7250 neonatal deaths, achieving average review rates of 83% for maternal deaths and 55% for neonatal deaths. Implementation operates at both community and facility levels, with timely death notification and verbal autopsies at the community level, involving frontline health workers and social autopsies to engage communities. Facility-level notification within 24 hours, facility death reviews are conducted within seven days, involving health care providers in the health facility. MPDSR committees oversee data review and local actions with a non-blaming approach. Revised National Guideline in 2021 aligned with global standards, emphasizing stillbirth reviews, midwives’ roles, and community engagement, overcoming blame culture etc. MPDSR video conferences found useful and effective for remote monitoring and developed video toolkits for consistent capacity development of healthcare providers. Integration into the DHIS-2 system allows real-time data monitoring and analysis across districts. Conclusions Bangladesh’s MPDSR system has made significant steps in reducing maternal mortality, integrating midwives, engaging communities, and deploying innovative tools, contributing to global efforts to achieve Sustainable Development Goals.