ENHANCING REVIEWS AND SURVEILLANCE TO ELIMINATE MATERNAL MORTALITY GRANT APPLICATION 2024. - Project Abstract Summary for the Enhancing Reviews and Surveillance To Eliminate Maternal Mortality (ERASE MM) Submitted by the Hawaii State Department of Health April 2024 Objectives: 1. To improve data quality and characterize pregnancy-related deaths. 2. To address health inequities by supporting the capacity to develop and implement data-informed strategies to prevent pregnancy-related deaths. 3. To reduce disparities among disproportionately impacted populations. General description: The United States faces a concerning challenge in its maternal mortality rates, standing out among high-income nations for its alarming incidence of maternal deaths despite substantial healthcare spending (American Medical Association, 2023). According to the Centers for Disease Control and Prevention (CDC), this inequity is pronounced when comparing moms from different racial and ethnic groups within the country. In Hawaii, the situation is no different from the rest of the nation, as race disparities and health inequities are noted within cases of severe maternal morbidity and pregnancy-related deaths. In Hawaii, approximately 10 to 12 women across the state die each year because of pregnancy or pregnancy-related complications. More than half of those deaths were deemed preventable. However, maternal morbidity and mortality do not affect all mothers equally. Native Hawaiian and Pacific Islander women experience maternal deaths at a higher rate, even though they make up a smaller proportion of women in the state, showing persistent ethnic disparities (CDC, 2019). Moreover, combined data from the MMRIA system (Maternal Mortality Review Information Application-CDC, a data system) indicated that mental health disorders, depression, and substance and alcohol use were essential factors in maternal mortality in Hawaii. Standardized data collection is the first step toward fully understanding the causes of maternal mortality and eliminating preventable pregnancy-related deaths. Efforts to review maternal deaths are not a novel practice. The Hawaii Maternal Mortality Review Committee (HMMRC) was established in 2016 and held its first review of maternal deaths in 2017. The purpose of this application is to support the Hawaii State Department of Health (HDOH) and HMMRC in identifying and characterizing pregnancy-related deaths for the prevention of similar deaths in the future. With the support of this grant, the HDOH, Health Resources Administration, Family Health Services Division, Maternal and Child Health Branch, will continue collecting vital records to assist with maternal death reviews ; abstract clinical/non-clinical data into the MMRIA system; identify pregnancy-related deaths; implement media campaigns with a focus on preventing maternal morbidity and mortality, especially among Native Hawaiians and Pacific Islanders; conduct informant or agency interviews to assist with individual case reviews; conduct multidisciplinary and multiagency reviews by diverse committees; and enter committee decisions into MMRIA. The ability to extract reports from the MMRIA data system will help support the HDOH and our partners in identifying maternal health preventative strategies and develop implementation plans for Hawaii, greatly limiting and reducing maternal deaths throughout the state.
