Maternal, newborn, child and adolescent health

The Maternal Death Surveillance and Response (MDSR) and perinatal audit


The Maternal Death Surveillance and Response (MDSR) and perinatal audit has been adapted from the established system of Maternal Deaths Review (MDR), with a focus on follow-up action and continuous monitoring of implementation of recommendations.

The overall purpose is to understand maternal and perinatal deaths (both numbers and causes) to inform improve policies, programs, and facility-level quality of care.

Achievements to date

Since the launch of the MDSR technical guidance in 2013, WHO has convened a Technical Working Group (TWG) of global experts on MDSR implementation to develop global guidance and tools, identify gaps, build capacity, and improve implementation.

A guide for audit and review of stillbirths and neonatal deaths was launched in 2016 including the ICD-PM application for classifying perinatal deaths. The MDSR Technical Working group now includes Perinatal Audit.

In March 2015, WHO and UNFPA implemented a global survey among Member States to monitor and document progress of MDSR implementation.

Several regional workshops on MDSR implementation and perinatal audit have been held, including innovative approaches for strengthening MDSR implementation through pre-service training.

Future plans

To discuss the issues and gaps in MDSR and Perinatal Audit implementation, an in-person meeting is planned for the TWG in November 2017. This will be an opportunity to create a work plan of relevant activities to address gaps in MDSR and Perinatal Audit implementation.

For audit and review of stillbirths and perinatal deaths, a smartphone application for assigning cause of death and ICD-PM code to perinatal deaths, is under development in collaboration with the Liverpool School of Hygiene and Tropical Medicine (LSTM). A pilot test for the application is planned during the second half of this year. Further, several countries have requested technical assistance for implementation as well as translation into the different WHO languages.

To improve the dissemination, a webinar is planned for the second half of the year as well as downloadable explanatory video clips on how to use the perinatal death review guide and the ICD-PM and issues requiring further explanation requested by countries.


For further information, please contact:

Allisyn Moran:

Nathalie Roos: