Technical Consultation on Reporting and Mapping Maternal Deaths in Countries with High Maternal Mortality

The objectives of the meeting were to share previous and ongoing work in this area, discuss priorities for future work, develop an action plan for moving forward, and provide recommendations to be disseminated at the Summit on Measurement and Accountability, sponsored by the World Health Organization (WHO), USAID, and World Bank, to be held in Washington, D.C., in June 2015. Approximately 72 participants from over 22 global health organizations, government agencies, donors, universities, and other groups participated in the meeting. The group concluded that mapping maternal deaths is important and work in this area should continue. In addition, the group concluded that maps that display related information to prevent maternal deaths are also needed; this information would include availability of care, quality of care, and other outcomes for maternal, perinatal, and newborn health. The group emphasized the importance of considering the end user when developing maps, as maps for facility-level managers or district health management teams may be different from maps for national-level policymakers. They also highlighted the need for standardization, including standardizing methods for data collection and mapping, as well as for collecting and compiling geocodes of health facilities. Throughout the Consultation, participants worked in small groups to develop and prioritize recommendations that would have the greatest impact to promote mapping of maternal deaths and other relevant indicators. The four groups addressed data sources and quality, data visualization and analysis, data use, and sustainability and scalability. Each of the groups identified a facilitator and a rapporteur, and developed recommendations that were shared with the larger group. The top 10 recommendations for maternal mortality mapping that will have the greatest impact include: 1. In addition to mapping maternal mortality, maps that display related information to prevent maternal deaths are also needed; this information would include availability of care, quality of care, and other outcomes for maternal, perinatal, and newborn health. 2. Maps should be developed based on available data and tailored to the question and the end user. 3. Standardization is essential, including standardizing methods for data collection and mapping, as well as for collecting and compiling geocodes of health facilities. 4. Capacity building is necessary at all levels, both in terms of capacity to use existing data to create maps and also in terms of capacity to interpret and understand maps to promote decision-making. 5. Data visualization using mapping and other techniques is a powerful tool that can visually display information, making it easier to understand and facilitate decision-making to adapt and improve programs and policies. 6. Maps should be developed to display 'layers' of information, including population information, geographic information, availability of functional health facilities, quality of facility-based care, and outcome measures such as mortality. 7. The use of geographic information systems (GIS) and global positioning systems (GPS) can be used to estimate travel time and improve decision-making. 8. The development of maps should be tailored to the end user, including facility-level managers, district health management teams, and national-level policymakers. 9. The use of standard data sources, such as the International Classification of Diseases (ICD), is essential for ensuring the quality and consistency of data. 10. The development of maps should be a collaborative effort, involving multiple stakeholders, including government agencies, donors, universities, and other global health organizations. These recommendations will form the basis of the action plan moving forward, and will be disseminated at the Summit on Measurement and Accountability in June 2015.