Background When used effectively, the Maternal and Perinatal Death Surveillance and Response (MPDSR) system can bring into reality a revolutionary victory in the fight against maternal and perinatal mortality from avoidable causes. This study aimed at determining the status of implementation of the system among health facilities in the Morogoro Region. Method This study was conducted among 38 health facilities from three districts of the Morogoro region, Tanzania, from April 27, 2020, to May 29, 2020. Quantitative data were collected through document review for MPDSR implementation status. The outcome was determined by using a unique scoring sheet with a total of 30 points. Facilities that scored less than 11 points were considered to be in the pre-implementation phase, those scored 11 to 17 were considered in the implementation phase, and those scored 18 to 30 were considered to be in the institutionalization phase. Results The majority 20(53 %) of health facilities were in the pre-implementation phase, only 15(40 %) of assessed health facilities were in the implementation phase, and few 3(8 %) of health facilities were in institutionalization phase. There was a strong evidence that MPDSR implementation was more advanced in urban compared to rural health facilities (Fisher’s test = 6.158, p = 0.049), hospitals compared to health centers (Fisher’s test =14.609, p <0.001) and private and faith-based organization than public facilities (Fisher’s test, 15.897 = p = 0.002). Conclusions The study revealed that health facilities in Morogoro Region have not adequately implemented the MPDSR system. The majority of health facilities in rural settings and owned by the government showed poor MPDSR implementation and hence called for immediate action to rectify the situation. Strengthen MPDSR implementation, health facilities should be encouraged to adhere to the available MPDSR guidelines in the process of death reviews. Transparent systems should also be established to ensure thorough tracking and follow-up of recommendations evolving from MPDSR reviews. Health facilities should also consider integrating MPDSR to other quality improvement teams to maximize its efficiency.

BackgroundMaternal and Perinatal Deaths Review and Surveillance (MPDSR) system when used effectively has the power to bring into reality, a revolutionary victory in the fight against maternal and perinatal mortality from avoidable causes. This study aimed at determining the status of implementation of the system among health facilities in rural settings of Tanzania.MethodThis study was conducted among 38 health facilities from three districts of Morogoro region, Tanzania from April 27, 2020 to May 29, 2020. Quantitative data was collected through document review for MPDSR implementation status. The outcome was determined by using special scoring sheet with a total 30 points. Facilities that scored 10 points or above were considered to have satisfactory status of MPDSR implementation while the facilities that scored below 10 points were considered to have unsatisfactory status of MPDSR implementation. Bivariate logistic regression analyses were used to determine the predictors of implementation status among health facilities.ResultsMajority of health facilities 20(52.6%) had satisfactory MPDSR implementation status. The predictors of MPDSR implementation in a facility were level of health facility [Hospital (AOR = 11.945 at 95% CI = 1.133 – 125.942, P = 0.039)] and ownership of the facility [Public (AOR = 0.133 at 95% CI = 0.019 – 0.920, P = 0.041)].ConclusionMPDSR implementation status among health facility is on average not satisfactory. More efforts are needed to raise the status of MPDSR implementation in the country so that the maximum benefit of MPDSR is obtained.

The maternal and Perinatal Deaths Surveillance and Response (MPDSR) system is a technical system that was issued by the World Health Organization in 2013 to help developing countries improve maternal health. The major purpose of the system is to reduce the ongoing high numbers of maternal deaths and perinatal deaths from avertable causes. Tanzania adopted the MPDSR system in 2015. This study aimed to determine the level of knowledge on the MPDSR system and its associated factors among health workers in the Morogoro region. Method: It was an analytical cross-sectional study conducted from April 27, 2020, to May 29, 2020. A multi-stage sampling technique was used to recruit 360 health workers. A semi-structured questionnaire was used to collect data. Statistical package for social science (SPSS v.20) software was used for data entry and analysis. Bivariate and multivariate logistic regression was used to assess factors associated with knowledge about MPDSR. Results: A total of 105 (29.2%) health workers in the Morogoro Region had adequate knowledge of the MPDSR system.After controlling for confounders, variables that showed significant association with knowledge of health workers on the MPDSR system were the level of health facility a health worker was working [Hospital (AOR = 2.668 at 95% CI = 1.497–4.753, p = 0.001)], level of education of a health worker [Diploma (AOR = 0.146 at 95% CI = 0.038–0.561, p = 0.005)] and status of training on MPDSR [trained (AOR = 7.253 at 95% CI = 3.862–13.621, p = < 0.001)]. Conclusion: The proportion of health workers who had adequate knowledge about MPDSR system in Morogoro Region is unacceptably low. Factors that associated with adequate knowledge were those working in hospital with higher level of professional training and who had ever had training on MPDSR. A cost effective strategy to improve the level of knowledge about MPDSR in the region is highly recommended.