Maternal mortality, near-miss and stillbirths in Suriname: Time to Respond

This thesis present studies on maternal mortality, maternal near-miss and stillbirths in Suriname with the aim to reduce maternal and perinatal mortality. The studies, conducted in a nationwide setting between 2015 and 2019, give insights into the incidence, case fatality rate, risk factors and substandard care of maternal mortality, maternal near-miss and stillbirths in Suriname.

PART I of the thesis describes the importance of maternal death and perinatal data surveillance and how surveillance contributes to developing adequate strategies and recommendations to reduce severe maternal and perinatal outcomes.

PART II increases the understanding of how women and baby die or nearly die by applying the World Health Organization classification tools for maternal mortality, near-miss and perinatal mortality. Furthermore, part II evaluates the applicability and feasibility of the tools and made recommendations to enhance uniformity and facilitates comparison within and between countries.

PART III goes beyond the numbers. While ratio’s and classifications provide us numbers (such as Part I and II of this thesis), they often fail to explain why events, such as maternal death, near-miss or stillbirth, occur and what we can do to prevent these events from happening. The next chapters go beyond the numbers, aimed at improving the quality of care and eliminating avoidable deaths.

Part IV of this thesis is part of the ‘response’ following the previous chapters. The descriptive process of facilitators and barriers of obstetric guidelines development and maternal death committee implementation can contribute to more efficient and effective interventions in Suriname and in other countries.