Nebraska has examined maternal mortality via a multidisciplinary Maternal Mortality Review Committee (MMRC) since 2014. There has been significant statewide investment and dedication to the MMRC since that time, with the committee and its role being incrementally developed over the last eight years. While substantial state commitment and interest persist, Nebraska MMRC requires technical and financial support to elevate the MMRC and ultimately reach the goal of reducing preventable pregnancy-related deaths and complications.
Nebraska aims to address known disparities in maternal mortality by increasing timeliness, accuracy, and standardization of available information about pregnancy-related deaths; improving multidisciplinary, population-level review of potential pregnancy-related deaths and documentation of recommendations for prevention; and improve dissemination, access to, and employment of quality maternal mortality data to drive opportunities for prevention.
In order to increase timeliness, accuracy, and standardization of information available about deaths during pregnancy and the year after the end of pregnancy, including documented opportunities for prevention, Nebraska intends to add probabilistic linkage to the case identification process; implement approaches for improving quality of death records through death certificate correction procedures with the Nebraska Vital Records Office; apply a consistent process for selecting deaths abstracted for committee review, including documenting false positive cases in Maternal Mortality Review Information Application (MMRIA); explore implementing informant interviews by creating standard processes and procedures; abstract and enter information about all maternal deaths into MMRIA within 18 months of death; document committee decisions on the MMRIA Committee Decision Form in MMRIA; and perform data quality assurance checks by developing a process to utilize data quality reports.
To improve multidisciplinary, population-level review of potential pregnancy-related deaths and documentation of recommendations for prevention, Nebraska MMRC plans to maintain a multidisciplinary review committee through multi-faceted support of current membership; and maintain a diverse review committee, inclusive of representatives from communities disproportionately impacted by pregnancy-related mortality by completing annual committee recruitment focusing on representation from communities that are diverse with regard to race, ethnicity, immigration status, English proficiency, and geographic region of the state.
Six strategies will be employed to improve dissemination, access to, and employment of quality MMRIA data to drive opportunities for prevention. They include fully operationalizing the MMRIA system to support core MMRC functions by piloting MMRC member utilization of MMRIA to view case abstracts; analyzing pregnancy-related MMRIA data; prioritizing recommendations for action; disseminating data products and related information from pregnancy-related analyses; developing and sustaining bidirectional partnerships with communities that increase the utilization of MMRC data to address disproportionate burdens of maternal mortality; and leveraging active collaborative partnerships focused on maternal health.