The United Nations Population Fund (UNFPA), through its 9th Country Programme, recently partnered with the Department of Health (DOH), the Ministry of Health−Bangsamoro Autonomous Region in Muslim Mindanao (MOH−BARMM), and the Consortium of Bangsamoro Civil Society (CBCS) to bring into fruition the five-day Training of Trainers (ToT) on Regional Maternal and Perinatal Death Surveillance and Response (MPDSR) for healthcare practitioners in BARMM from December 15 to 19, 2025, at Astoria Plaza, Ortigas District, Pasig City. The initiative aims to equip health managers and providers from across the region with the critical skills to identify and notify maternal and perinatal mortality, review and analyze causes, and formulate, implement, and monitor responses to curb the occurrence of preventable deaths and enable the delivery of quality maternal and newborn healthcare.
As Ms. Rochelle Yu, Head of the UNFPA Sub-office in Cotabato, pointed out, the MPDSR “is a practical and accountable process. One that allows us to review each maternal and newborn death and also helps us improve the quality of care for mothers and newborns in the BARMM.”
The training underscores UNFPA’s commitment to uplift the lives of women in BARMM, particularly by expanding pregnant women’s access to comprehensive sexual and reproductive health information and services, improving policy directions on maternal health, and accelerating the reduction of maternal deaths.
Turning Data into Action
The MPDSR is an established system for tracking all maternal and perinatal deaths in real time and reviewing the underlying factors contributing to the deaths, with the end goal of using the information obtained to guide public health actions aimed at eradicating preventable maternal and perinatal mortality.
According to Dr. Kusum Thapa, the master trainer for the workshop and the current president elect of the South Asian Federation of Obstetrics and Gynaecology, “evidence suggests that if maternal and perinatal death reviews are completed and recommendations are implemented alongside training and development of local leadership, a 30-35% reduction in maternal and perinatal mortality can be observed.” She further stressed that the system offers an opportunity for the correction of specific causes of death, reduction of the “three delays,” and designing of localized solutions.
By enhancing the capacity of a core group of medical practitioners in MPDSR, who will in turn cascade their knowledge and skills in implementing the system to other health providers in the provincial and local facility levels, as well as in communities, BARMM will eventually be able to benefit from a more robust, resilient, and responsive MPDSR system.
Strengthening Maternal and Perinatal Healthcare Response in BARMM
The training participants consisted of obstetrician-gynecologists, pediatricians, nurses, and municipal health officers from MOH−BARMM, Cotabato Regional Medical Center, Amai Pakpak Medical Center, and the Bangsamoro Regional Hospital and Medical Center. To ensure that they provide honest, evidence-based medical reviews and prompt, quality health responses, Dr. Thapa, along with Dr. Annette Macayaon, Chair of the Philippine Obstetrical and Gynecological Society’s (POGS) Subcommittee on Maternal Death Reduction, who provided support in conducting the training, comprehensively discussed the key concepts embedded in the MPDSR system, such as the “No Name, No Blame” policy, the Three Delays Model, and the Six-Step Mortality Audit Cycle, among others.
Shifting the Culture: “No Name, No Blame”
Healthcare providers are vulnerable to blame; hence, the MPDSR used to be feared as a “blame game.” The adoption of the “No Name, No Blame” policy in the MPDSR has then provided a safe ground for an honest review process. It ensures legal protection for healthcare providers and shields them from a “blame and shame” culture.
Moreover, as reviews are meant to be confidential and non-punitive, the policy enables a straightforward identification of gaps and failures in the health system, thus making it possible to address the issues. Nonetheless, “no blame” does NOT mean no accountability.
Addressing Delays to Save the Next Mother
Emphasis was also made on identifying the cause of maternal or newborn death using the Three Delays Model:
- Delay 1: Recognition and decision to seek care. Delay in deciding to seek care is often caused by a lack of awareness of “danger signs,” financial barriers, or cultural practices.
- Delay 2: Transport to care. Delay in reaching care usually stems from geographical challenges, poor road infrastructure, or lack of transport or medical facilities in some impoverished areas.
- Delay 3: Receiving quality care. Delay in receiving care once the patient reaches the hospital is often the result of a shortage in skilled personnel, equipment, medicine, or blood supply, among others.
Dr. Thapa stressed the importance of being able to understand any maternal or newborn death that happens in a facility, based on the three delays, to identify underlying modifiable factors and formulate a correct action plan.
Closing Gaps through the Six-Step MPDSR Cycle
Another key component of the MPDSR system is the Six-Step Mortality Audit Cycle, a continuous quality improvement process that provides a systematic strategy for identifying, understanding, and addressing preventable factors contributing to maternal and perinatal deaths. It generates actionable, evidence-based recommendations and allows for an evaluation and refinement of the responses made to prevent future tragedies.
The six steps are as follows: (1) Identification of Cases, (2) Information Collection, (3) Information Analysis, (4) Recommendation of Solutions, (5) Implementation of Recommendations, and (6) Monitoring, Evaluation, and Refinement.
Making a Commitment to End Preventable Maternal and Perinatal Deaths in BARMM
The workshop concluded with all the participants drafting and presenting their action plans to create or strengthen their respective MPDSR committees and to cascade all their MPDSR learning down to the provincial, facility, and community levels.
Ms. Rochelle Yu officially ended the training with a hopeful note that the MPDRS system will be fully implemented in BARMM “for the women and girls of the Bangsamoro.” She also promised to support the participants in implementing their action plans.
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