ArticlePloS one2018
Underreporting of deaths in the maternal deaths surveillance system in one region of Morocco.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Incompleteness and misclassification of maternal death recording: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2023Pooled it
- Trends in maternal mortality and stillbirths by county in health facility data, Kenya, 2011-2022.BMC pregnancy and childbirth · 2025Article
- Maternal mortality in Goiás: Causes of maternal death and barriers to underreporting.PLOS global public health · 2025Article
- The quality of routine data for measuring facility-based maternal mortality in public and private health facilities in Kampala City, Uganda.Population health metrics · 2024Article
- Causes of maternal deaths in Sierra Leone from 2016 to 2019: analysis of districts' maternal death surveillance and response data.BMJ open · 2024Article
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- Exploring variations in the implementation of a health system level policy intervention to improve maternal and child health outcomes in resource limited settings: A qualitative multiple case study from Uganda.PLOS global public health · 2024Article
- Value of Verbal Autopsy in a Fragile Setting: Reported versus Estimated Community Deaths Associated with COVID-19, Banadir, Somalia.Pathogens (Basel, Switzerland) · 2023Article
- Eight-year experience of maternal death surveillance in Morocco: qualitative study of stakeholders' views at a subnational level.BMC public health · 2022Article
- Maternal Mortality in Africa: Regional Trends (2000-2017).International journal of environmental research and public health · 2022Article
- Classifying maternal deaths in Suriname using WHO ICD-MM: different interpretation by Physicians, National and International Maternal Death Review Committees.Reproductive health · 2021Article
- Analysis of the Iranian maternal mortality surveillance system and providing system improvement strategies: study protocol for strategy formulation.Reproductive health · 2020Article
- Causes of maternal deaths and delays in care: comparison between routine maternal death surveillance and response system and an obstetrician expert panel in Tanzania.BMC health services research · 2020Article
- Beyond No Blame: Practical Challenges of Conducting Maternal and Perinatal Death Reviews in Eastern Ethiopia.Global health, science and practice · 2020Article
- Article
- Implementation of maternal death audits and changes in maternal health care in Cambodia, 2010-2017.Western Pacific surveillance and response journal : WPSARArticle
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the reliability of maternal deaths surveillance system (MDSS) and to determine the factors that influence its completeness in one region of Morocco.
methodsWe conducted a retrospective survey in "Gharb Chrarda Bni Hssen" region (GCBH) between January the 1st, 2013 and September the 30th, 2014 using multiple sources approach. All deaths of women of reproductive age (WRA) were investigated using certificates with medical cause, medical records and interviews with household members and relatives to ascertain a pregnancy-related or maternal death. An External Expert Committee reviewed the information collected to assign a cause for each death. Our results were compared to those reported in the same period by the MDSS.
findingsOur study identified 690 deaths of WRA and 69 maternal deaths of which 34.8% occurred outside health facilities. The MDSS recorded during the study period 538 deaths of WRA and 29 maternal deaths (including only one outside health facility) representing respectively an underreporting of 22.0% and 58.0%. Late maternal deaths represented 11.4% of all deaths of women with a registered pregnancy within 12 months prior to the death, while the MDSS identified none. The maternal mortality ratio (MMR) was estimated at 103, approximately 2.5 times higher than that reported in the MDSS.
conclusionOur study has shown weaknesses in the current notification system for maternal deaths in the region of GCBH. Therefore, more attention must be given to the regional committees in charge of auditing the cases and defining actions to be implemented to prevent further maternal deaths.
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