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FIELD ACTION REPORT
Open Access

From Passive Surveillance to Response: Suriname's Efforts to Implement Maternal Death Surveillance and Response

Lachmi R. Kodan, Kim J. C. Verschueren, Geertje Boerstra, Inder Gajadien, Robert S. Mohamed, Lily D. Olmtak, Satish R. Mohan and Kitty W. M. Bloemenkamp
Global Health: Science and Practice June 2021, 9(2):379-389; https://doi.org/10.9745/GHSP-D-20-00594
Lachmi R. Kodan
aAcademic Hospital Paramaribo, Paramaribo, Suriname.
bDepartment of Obstetrics, Division Women and Baby, Birth Centre Wilhelmina's Children Hospital, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
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  • For correspondence: lachmikodan@yahoo.com
Kim J. C. Verschueren
bDepartment of Obstetrics, Division Women and Baby, Birth Centre Wilhelmina's Children Hospital, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
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Geertje Boerstra
cPan American Health Organization, Paramaribo, Suriname.
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Inder Gajadien
dBureau of Public Health Suriname, Paramaribo, Suriname.
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Robert S. Mohamed
eMinistry of Health Suriname, Paramaribo, Suriname.
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Lily D. Olmtak
fDiakonessen Hospital, Paramaribo, Suriname.
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Satish R. Mohan
g's Lands Hospital, Paramaribo, Suriname.
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Kitty W. M. Bloemenkamp
bDepartment of Obstetrics, Division Women and Baby, Birth Centre Wilhelmina's Children Hospital, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
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Figures & Tables

Figures

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  • FIGURE 1
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    FIGURE 1

    Timeline of Local Plans to Reduce Maternal Mortality in Suriname up to 2015

  • FIGURE 2
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    FIGURE 2

    Maternal Death Surveillance and Response in Suriname in 2020

    Source: Adapted from the World Health Organization.7

  • FIGURE 3
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    FIGURE 3

    Facilitators and Barriers in Establishing Maternal Death Surveillance and Response in Suriname as Experienced by Committee Maternal Mortality Suriname Members, Health Care Providers, and Public Health Experts

    Abbreviations: BOG, Bureau of Public Health; MDSR, Maternal Death Surveillance and Response; MaMS, Maternal Mortality Suriname, MOH, Ministry of Health; PAHO, Pan American Health Organization.

  • FIGURE 4
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    FIGURE 4

    Timeline of Maternal Health Initiatives in Suriname, 2015 to Present

    Abbreviation: M(P)DSR: maternal (& perinatal) death surveillance and response.

  • FIGURE 5
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    FIGURE 5

    Flowchart of Organization of Maternal Health in Suriname Adapted From the National Maternal Health and Mortality Reduction Priority Plan 2019–202036

  • FIGURE 6
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    FIGURE 6

    The Ideal Paradigm of the Maternal and Perinatal Death Surveillance and Response Cycle for Suriname

    Abbreviation: MPDSR, maternal and perinatal death surveillance and response.

Tables

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    TABLE 1.

    Summary of the Implementation Status of Maternal Death Surveillance and Response in 2020

    Already EstablishedTo Be Established
    • Installation of a national review committee (MaMS) and a maternal health mortality reduction steering committee

    • Coordination framework and terms of references

    • Institutional MDSR focal points designated and trained in surveillance and active case detection

    • Quality-of-care working group operational

    • National policy for notification of maternal deaths

    • Official installation of committee MaMS and the 4 working groups for maternal health, reinforce the health promotion and perinatal data working groupa

    • Facility-based audits of every case, organized by MDSR focal points

    • Verbal autopsies by MDSR focal pointsb

    • Specialized assessors for facility audit preparation (nurses, doctors) and external audits (BOG)

    • Timely dissemination of recommendations

    • Monitoring and evaluation

    • Abbreviations: BOG, Bureau of Public Health; MaMS, Maternal Mortality Suriname; MDSR, Maternal Death Surveillance and Response.

    • ↵a Perinatal data working group was installed, but only sporadically active.

    • ↵b Only incidentally performed until now.

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    TABLE 2.

    Summary of Recommendations From Committee Maternal Mortality Suriname Members, Health Care Providers, and Public Health Experts to Strengthen Maternal Death Surveillance and Response in Suriname

    Legislation
    • Ensure no disciplinary/litigation measures

    • Notification of maternal death within 24 hoursa

    • Include pregnancy checkbox on the death certificateb

    • Timely completion of death certificate

    • Autopsy for maternal deaths of unknown cause

    Finances and human resources
    • Empower BOG by capacity strengthening

    • Support committee MaMS (administrative personnel, logistics)

    • Capacity building of the institutional MDSR focal points

    • Include MDSR in preservice training curricula

    • Involve health care workers and create awareness (bottom-up approach)

    • Involve and educate the community

    • Funding

    Enabling policies
    • Ensure structural facility-based review

    • Install special secretariat for MDSR at BOG/MOH

    • Enable communication and dissemination of findings and recommendations

    • Abbreviations: BOG, Bureau of Public Health; MaMS, Maternal Mortality Suriname; MDSR, Maternal Death Surveillance and Response; MOH, Ministry of Public Health.

    • ↵a Institutions and funeral agencies were recently requested to report maternal deaths within 24 hours.

    • ↵b As a temporary solution, a pregnancy checkbox slip is attached to the “C form.”

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Global Health: Science and Practice: 9 (2)
Global Health: Science and Practice
Vol. 9, No. 2
June 30, 2021
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From Passive Surveillance to Response: Suriname's Efforts to Implement Maternal Death Surveillance and Response
Lachmi R. Kodan, Kim J. C. Verschueren, Geertje Boerstra, Inder Gajadien, Robert S. Mohamed, Lily D. Olmtak, Satish R. Mohan, Kitty W. M. Bloemenkamp
Global Health: Science and Practice Jun 2021, 9 (2) 379-389; DOI: 10.9745/GHSP-D-20-00594

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From Passive Surveillance to Response: Suriname's Efforts to Implement Maternal Death Surveillance and Response
Lachmi R. Kodan, Kim J. C. Verschueren, Geertje Boerstra, Inder Gajadien, Robert S. Mohamed, Lily D. Olmtak, Satish R. Mohan, Kitty W. M. Bloemenkamp
Global Health: Science and Practice Jun 2021, 9 (2) 379-389; DOI: 10.9745/GHSP-D-20-00594
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  • Article
    • ABSTRACT
    • BACKGROUND
    • MATERNAL DEATH SURVEILLANCE AND SAFE MOTHERHOOD INITIATIVES BEFORE 2015 IN SURINAME
    • MDSR IMPLEMENTATION PROCESS IN SURINAME BETWEEN 2015 AND 2019
    • 2020 AND BEYOND: NEXT STEPS TOWARD FULFILLING THE MDSR CYCLE IN SURINAME
    • CONCLUSIONS
    • Acknowledgments
    • Author contributions
    • Competing interests
    • Notes
    • REFERENCES
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