1. Maternal and Neonatal Death Surveillance and Reporting System Assessment

Maternal & neonatal mortality remain a challenge in Punjab. An important element that can contribute towards reduction in these mortalities is an effective surveillance and response system. The Government of Punjab has established a Maternal & Neonatal Death Surveillance and Response (MNDSR) system across the province. However, the effectiveness of this system was never assessed. The IRMNCHNP & UNFPA commissioned SPHERE Consulting to conduct an assessment of the MNDSR system to document the existing process and challenges in reporting and response of mortalities; and to suggest recommendations to upgrade and streamline the system. SPHERE Consulting conducted this study through a comprehensive assessment in selected districts, i.e., Lahore, Sheikhupura, Rawalpindi, and Muzaffargarh. Employing a qualitative assessment approach, the study involved participation of various healthcare cadres, including Lady Health Workers (LHWs), Lady Health Supervisors (LHSs), Lady Health Visitors (LHVs), District Coordinators, and Provincial representatives from the Integrated Reproductive, Maternal, Newborn and Child Health & Nutrition Program (IRMNCH&NP). Feedback was also taken from UNFPA and WHO, to ensure that the recommendations remain in line with international best practices, and to ensure uniformity across various community based and facility based reporting systems. The assessment report not only highlighted areas of improvement but also provided insightful recommendations to IRMNCH&NP for refining and strengthening the existing surveillance and response system, and is expected to contribute in better identification of causes of mortality and thereby enabling the Program to implement preventive strategies.