Community surveillance and response to maternal and child deaths in low- and middleincome countries: A scoping review
Date
2021-03-16
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Abstract
Background
Civil registration and vital statistics (CRVS) systems do not produce comprehensive data on
maternal and child deaths in most low- and middle-income countries (LMICs), with most
births and deaths which occur outside the formal health system going unreported. Community-based death reporting, investigation and review processes are being used in these settings to augment official registration of maternal and child deaths and to identify deathspecific factors and associated barriers to maternal and childcare. This study aims to review
how community-based maternal and child death reporting, investigation and review processes are carried out in LMICs.
Methods
We conducted a scoping review of the literature published in English from January 2013 to
November 2020, searching PubMed, EMBASE, PsycINFO, Joanna Briggs, The Cochrane
Library, EBM reviews, Scopus, and Web of Science databases. We used descriptive analysis to outline the scope, design, and distribution of literature included in the study and to
present the content extracted from each article. The scoping review is reported following the
PRISMA reporting guideline for systematic reviews.
Results
Of 3162 screened articles, 43 articles that described community-based maternal and child
death review processes across ten countries in Africa and Asia were included. A variety of
approaches were used to report and investigate deaths in the community, including identification of deaths by community health workers (CHWs) and other community informants, reproductive age mortality surveys, verbal autopsy, and social autopsy. Community
notification of deaths by CHWs complements registration of maternal and child deaths
missed by routinely collected sources of information, including the CRVS systems which
mostly capture deaths occurring in health facilities. However, the accuracy and completeness of data reported by CHWs are sub-optimal.
Conclusions
Community-based death reporting complements formal registration of maternal and child
deaths in LMICs. While research shows that community-based maternal and child death
reporting was feasible, the accuracy and completeness of data reported by CHWs are suboptimal but amenable to targeted support and supervision. Studies to further improve the
process of engaging communities in the review, as well as collection and investigation of
deaths in LMICs, could empower communities to respond more effectively and have a
greater impact on reducing maternal and child mortality.