Legal issues in the implementation of maternal death surveillance and response (MDSR): a scoping review.

Autor:	Kidanemariam MB; Faculty of Law, University of Bergen, Magnus Lagabøtes Plass 1, 5010 Bergen, Norway., Kidanemariam MB; Faculty of Law, University of Bergen, Norway and School of Law, Mekelle University, Ethiopia., Miljeteig I; Bergen Center for Ethics and Priority Setting in Health (BCEPS), University of Bergen, Norway., Moland KM; Centre for International Health, University of Bergen, Norway., Melberg A; Bergen Center for Ethics and Priority Setting in Health (BCEPS), University of Bergen, Norway.
Jazyk:	angličtina
Zdroj:	Health policy and planning [Health Policy Plan] 2024 Aug 03. Date of Electronic Publication: 2024 Aug 03.
DOI:	10.1093/heapol/czae071
Abstrakt:	The Maternal Death Surveillance and Response (MDSR) system is designed to continuously identify and review all maternal deaths. It aims to assist countries in understanding the scale and distribution of maternal deaths, identifying their causes, and informing corrective measures to address the challenge. Despite the growing adoption of the MDSR by numerous low- or middle-income countries, its implementation faces various challenges, including legal ones. This scoping review was conducted to map legal issues and challenges that arise during the implementation of the MDSR. It adapted the Bain and Kongnyuy framework, categorising legal issues into data, people, use of findings, and legal regulation. Literature was retrieved from seven databases, complemented by additional online searches. We included studies published in English between 2010 and November 2022 that report on legal issues arising during the implementation of MDSR. Out of 1,174 studies screened, 31 were selected for review. The review highlighted the limited attention given to the legal dimension of the MDSR by the research community. It also documented the lack of adequate legal framework essential for the system's effective implementation. Inadequate safeguards for informational privacy and the lack of confidentiality reinforce a prevalent sense of being blamed, mainly among health workers. Consequently, widespread underreporting and intentional misattribution of causes of maternal death, defensive referrals, and disengagement from the MDSR process were reported. We recommend that implementing countries regulate the gathering and use of MDSR data through suitable laws and legally ensure that the MDSR data are only used for the intended purpose. Appropriate complaint-handling mechanisms are needed in health systems to prevent the misuse of the MDSR. Future studies on MDSR implementation would benefit from involving legal experts, considering the multifaceted legal dimensions of the MDSR. (© The Author(s) 2024. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.)
Databáze:	MEDLINE
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