Reginald F. Gipson, MD, MPH¹, Esmat Mansour Ibrahim El Sharkably, MD, MPH, PhD², and Adel Hakim Issa, MD, MSc¹. (1) Healthy Mother/Healthy Child, John Snow, Inc., 21 Misr Helwan Agricultural Rd., 10th floor, Maadi, Cairo, Egypt, 011 202 359 1487, rgipson@jsiegypt.com, (2) Undersecretary for Primary Health, Ministry of Health and Population, Egypt, 21 El-Sabaa Sakayat St., Kasr el Eini, Cairo, Egypt

Two National Maternal Mortality Surveys (NMMS) were conducted in Egypt in 1992/93 and 2000. The results showed that the Maternal Mortality Ratio (MMR) dropped in that period from 174 to 84/100,000 live births. The Ministry of Health and Population (MOHP) wants to reduce it by a further 42% (to 50/100,000) by 2007.

The national surveys were conducted in 149 selected health offices. Data from family and health provider-interviews were compiled into a single form in which causes and avoidable factors contributing to maternal death were determined.

The Maternal Mortality Surveillance System (MMSS) was introduced by the MOHP in 1998 and revised in 2001 by the MOHP with technical assiatnce provided by John Snow, Inc. The MMSS is more cost-effective than the surveys because it uses the system already in place (MOHP forms and employees). The interviews were simplified rendering them more cost- and time-effective and more user friendly (the newly created 3-page MMSS questionnaire replaced 2 separate forms totaling around 50 pages).

The MMSS results not only in an analysis of deficiencies but also in corrective action plans. Because the MMSS delivers mortality data on a monthly basis, policy decisions and action plans are implemented in a timely fashion on an ongoing basis and provides regional information for the management of safe motherhood programs.

The MMSS itself is constantly under review through the system of performance scores calculated in a self-assessment format at all levels. It is thus continuously monitored for quality and corrective action is taken whenever necessary.

Learning Objectives:

• Compare advantages and disadvantages of maternal mortality surveys versus a surveillance system.
• Discuss the uses of maternal mortality surevys and surveillance systems for the management of safe motherhood programs.

Keywords: Developing Countries, MCH Epidemiology

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.