TY - JOUR T1 - Authors' Response to Editorial: Maternal Death Surveillance and Response: A Tall Order for Effectiveness in Resource-Poor Settings JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT SP - 697 LP - 698 DO - 10.9745/GHSP-D-17-00407 VL - 5 IS - 4 AU - Helen Smith AU - Charles Ameh AU - Pamela Godia AU - Judith Maua AU - Kigen Bartilol AU - Patrick Amoth AU - Matthews Mathai AU - Nynke van den Broek Y1 - 2017/12/28 UR - http://www.ghspjournal.org/content/5/4/697.abstract N2 - See related articles by Koblinsky and by Smith et al.We thank Marge Koblinksy for her considered editorial1 on the Maternal Death Surveillance and Response (MDSR) approach used in Kenya and lessons learned, described in our recent article published in GHSP.2 Her views on the potential effectiveness of MDSR in resource-limited settings, however, seem pessimistic.Firstly, Koblinsky argues that MDSR is too complicated and demanding in low- and middle-income countries, and should be abandoned in favour of investment in lifesaving interventions. We argue, however, that investment must be made in ensuring availability of care as well as quality of this care for interventions to be lifesaving. Most maternal deaths in low- and middle-income countries result from obstetric complications. The care packages to prevent and manage these complications are established and evidence-based. Most maternal deaths occur because complications are not recognized on time, women do not receive these interventions on time, or care given may be substandard.Secondly, Koblinsky criticizes the assessment of factors contributing to maternal deaths in the national report from Kenya—incorrect management, insufficient monitoring, and delay in taking action when needed—as being too general. Yet these are exactly the reasons why women die. For example, the failure to identify severe hemorrhage early and to take timely and adequate action … ER -