ESSENTIAL REVISIONS IN THE MATERNAL MORTALITY SURVEILLANCE SYSTEM: LESSONS LEARNED FROM A QUALITATIVE STUDY

AFSANEH KARIMI¹, FARAHNAZ SADOUGHI², REZA MAJDZADEH³

¹Health Information Management Department, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran - ¹Health Information Technology Department, Paramedical School, Zahedan University of Medical Sciences, Zahedan, Iran - ²Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran - ³Knowledge Utilization Research Center (KURC), Tehran University of Medical Sciences (TUMS), Tehran, Iran - ³Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran

Background: Iran has been able to achieve the MDG 5, but continued success in this direction seems to be difficult due to changes in the country’s family planning policy, which is to increase the population. Therefore, it is important to determine the status of the Iranian Maternal Mortality Surveillance System (IMMSS) to identify its pros and cons and to try to improve its quality; this is the aim of this study.

Methods: Using the content analysis approach, this qualitative study was conducted in 2016. It had two stages: the review of all related documents and the interviews of 15 key informants. The data were analyzed through framework analysis and the results were presented using a descriptive method.

Results: The implementation of various programs, interventions to improve maternal health and the achievement of the MDG 5 were found to be the most important strengths of the IMMSS. There are several weaknesses in the system, including a lack of clear information about morbidities caused by pregnancy and birth, repeated maternal deaths due to similar causes and the lack of a sys- tem evaluation at the provincial level.

Conclusions: We found that the IMMSS is useful. However, certain measures are recommended to improve the system perfor- mance quality. These are, for example, the establishment of a system for the surveillance of maternal morbidities and high-risk moth- ers, and the evaluation of a maternal mortality surveillance system at the provincial level.