MPDSR Policy Summary

What Is This Policy?

The National Guidelines for Maternal and Perinatal Death Surveillance and Response (MPDSR) are Nigeria’s foundational operational framework for eliminating preventable maternal and perinatal deaths. MPDSR is a continuous cycle of identification, notification, review, and response to every maternal and perinatal death — whether occurring in a health facility or community — linking the health information system and quality-improvement processes from local to national level. The guidelines establish the institutional structures, committee mandates, tools, and step-by-step procedures for conducting death reviews across all three tiers of government, and translate each death’s story into targeted recommendations that prevent future deaths. First issued in 2014, the guidelines were revised in 2019 and expanded in 2022 to incorporate Child Death Audit, making the system the Maternal, Perinatal and Child Death Surveillance and Response (MPCDSR).

Who Does It Target?

Policy makers and health administrators at federal, state, and local government levels Obstetricians, gynaecologists, paediatricians, neonatologists, nurses, midwives, anaesthetists, pathologists, and pharmacists in tertiary, secondary, and primary health facilities Community health extension workers (CHEWs), community health officers (CHOs), traditional birth attendants (TBAs), and disease surveillance information officers at LGA level National and state MPDSR steering committees, facility MPDSR committees, and community-based MPDSR committees MNCH service managers and providers, including hospital administrators and medical records officers Non-governmental organisations, civil society organisations, development partners (WHO, UNFPA, UNICEF), women’s groups, and community leaders

What Does It Aim to Achieve?

Eliminate preventable maternal and perinatal deaths by obtaining, analysing, and strategically using information on every death to guide public health actions and monitor their impact Notify, count, and collect accurate data on all maternal and perinatal deaths nationwide, including causes, contributing factors, and avoidability assessments at facility, state, and national levels Generate evidence-based recommendations for action across community education, referral timeliness, quality of care, training, resource deployment, regulations, and policy Disseminate findings and recommendations to civil society, health personnel, and decision-makers to increase awareness of the magnitude and preventability of maternal and perinatal mortality Ensure implementation of recommendations is monitored, evaluated, and reported, creating a closed feedback loop from death to action Strengthen accountability for maternal and perinatal health and improve civil registration and vital statistics records across Nigeria

Key Features

Three-Tier Review Structure: Parallel and interconnected MPDSR committees operate at national (FMoH), state (SMoH), facility (tertiary/secondary/PHC), and community levels, each with defined membership, terms of reference, and reporting lines No Name, No Blame: All reviews are conducted under a strict code of confidentiality and non-punitive conduct; no names of deceased or providers are used in any report or deliberation Continuous Surveillance Cycle: Every maternal and perinatal death triggers immediate notification (within 24 hours), data collection (within 72 hours), a facility committee review (every 2–4 weeks), and a written action plan dispatched to the MPDSR Desk Officer Verbal Autopsy for Community Deaths: Community-Based MPDSR (CBMPDSR) uses structured Verbal Autopsy (VA) interviews to capture all deaths occurring at home or in transit — ensuring no preventable death goes unaudited regardless of place of death Standardised Tools: A suite of nationally approved forms covers death notification (MPDSR Form 1), facility-based death review (MPDSR Form 2), recommendations and action plan (MPDSR Form 3), quarterly response tracking (Form 4), and perinatal death review (PNDR 1 & 2) Legislation & Institutionalisation: MPDSR Bill passed the National Assembly and is awaiting Presidential assent; maternal and perinatal deaths are classified as notifiable conditions reportable to Disease Surveillance Information Officers

Current Status

Rollout Stage: Active — MPDSR State Steering Committees established in all 36 states and FCT; facility-level MPDSR operational in most secondary and tertiary health facilities nationally Scale-up: Pilot commenced in all Federal Government-owned tertiary health facilities (Phase 1); expanded to state secondary facilities and private hospitals (Phase 2); community Verbal Autopsy integrated at PHC level (Phase 3) Mortality Burden: Nigeria accounts for approximately 10% of global maternal deaths; an estimated 58,000 women die annually from pregnancy-related causes, with a maternal mortality ratio of 576 per 100,000 live births and neonatal mortality of 37 per 1,000 live births MPCDSR Expansion: In 2022, child death audits were integrated into the system following WHO-AFRO guidance, expanding coverage to the full maternal-perinatal-child mortality continuum Digital Platform: A national MPDSR e-platform, linked to Nigeria’s Integrated Disease Surveillance and Response (IDSR) system and the National Population Commission (NPC), provides real-time mortality data and improved reporting timeliness Partnerships: UNICEF, WHO, UNFPA, Evidence for Action (E4A), Save the Children, Jhpiego, USAID, and Rotary International support implementation, training, and community-level MPDSR across all states

How to Access

Health Facilities: Establish a Facility MPDSR Committee chaired by the Chairman, Medical Advisory Committee; train all MNCH staff; initiate death notification within 24 hours of every maternal or perinatal death using MPDSR Form 1 State Governments: Constitute a State MPDSR Steering Committee domiciled in the Office of the Permanent Secretary for Health; appoint a state MPDSR coordinator; ensure quarterly reporting to the national steering committee Community Leaders & LGA Officers: Establish a CBMPDSR Committee with broad-based community representation; train investigators in Verbal Autopsy; notify Disease Surveillance Information Officer within 7 days of any suspected maternal or perinatal death Development Partners: Access partnership frameworks through the FMoH Department of Family Health; engage through the national MPDSR Steering Committee technical sub-committee for training, tools, and resource mobilisation Contact: Federal Ministry of Health — MPDSR Desk Officer, Department of Family Health, Reproductive Health Division, Abuja | fmoh.gov.ng | nphcda.gov.ng

Important Terms

Maternal Death: The death of a woman while pregnant or within 42 days of termination of pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes Perinatal Death: A death occurring around the time of birth; encompasses both stillbirths (foetal deaths ≥28 weeks gestation / ≥1,000g) and early neonatal deaths (death within the first 7 days of life) Verbal Autopsy (VA): A structured interview method using a standardised questionnaire to reconstruct the circumstances, signs, and symptoms leading to a death in the community, enabling cause-of-death assignment without clinical records Three Delays Model: A framework examining maternal deaths for three preventable delay types: (1) delay in deciding to seek care; (2) delay in reaching a health facility; and (3) delay in receiving adequate care at the facility MPDSR Desk Officer: A dedicated officer, at minimum Assistant Director rank, domiciled in the FMoH Department of Family Health, responsible for compiling all facility MPDSR reports and presenting them to the National Steering Committee

Impact & Metrics

Nigeria accounts for approximately 10% of global maternal deaths despite representing only 2.5% of global population — MPDSR directly targets this disproportionate burden Every day in Nigeria, approximately 700 babies die; this is the highest number of newborn deaths in Africa and the second highest in the world For every maternal death, at least seven newborns die and a further four babies are stillborn — the MPDSR cycle is designed to address the shared causative factors driving all three outcomes MPDSR State Steering Committees now established in all 36 states and the FCT; the national e-platform has confirmed measurably improved timeliness and completeness of mortality data capture 64.2% of births in Nigeria still occurred outside health facilities at baseline (2013 NDHS); community-level MPDSR and Verbal Autopsy are specifically designed to reach these unaudited deaths

Official Resources

Website: fmoh.gov.ng | nphcda.gov.ng | nationalqoc.fmohconnect.gov.ng Policy Document: National Guidelines for MPDSR in Nigeria (2014; revised 2019) — available via FMoH Department of Family Health and the National Quality of Care platform Contact: MPDSR Desk Officer, Reproductive Health Division, Department of Family Health, Federal Ministry of Health, Abuja, Nigeria Summary prepared using the Policy Summary Template | Source: National Guidelines for MPDSR in Nigeria 2014/2019, FMoH Nigeria, WHO, UNFPA, UNICEF, SOGON, PAN, Evidence for Action | March 2026

Legal Framework

The National Guidelines for Maternal and Perinatal Death Surveillance and Response (MPDSR) operate under the National Health Act 2014, the Vital Registration Act, and the National Population Commission Act (on vital statistics). They align with WHO Guidelines for MPDSR (2016), the SDG 3.1 and 3.2 targets on maternal and child mortality reduction, and the African Union's Maputo Plan of Action on Sexual and Reproductive Health and Rights.