Maternal Mortality in Suriname: Implementation of Maternal Death Surveillance and Response to reduce preventable maternal deaths

In order to achieve the Sustainable Development Goals on maternal mortality, it is crucial to implement the maternal death surveillance and response (MDSR) cycle in Suriname. Our nationwide research focussed on the prevalence, risk factors and causes of maternal mortality. The prevalence appeared to be much higher than reported, with great disparities among women of different ethnicities (African-descendents have the highest risk). The most important causes of maternal mortality were bleeding, high blood pressure, and infections. The challenges we encountered during the classification of deaths entail, among other things, that experts classify the same deaths differently. Audit (critical evaluation) of why women died was more the consequence of substandard care in hospitals than due to patient or transport delay. Therefore national guidelines were developed conform the “bottom-up” strategy. Also, a committee on maternal mortality Suriname was installed to systematically review the maternal deaths. Almost half of the maternal deaths in the recent five years occurred at home or at the peripheral clinic and in women in already deplorable state on arrival at the hospital. Also, maternal deaths from hypertensive diseases, unspecified causes, suicide, and abortive outcomes increased in recent years. To successfully implement MDSR in Suriname strong government and healthcare providers commitment and leadership are essential.