This application will address a major public health problem regarding maternal mortality underreporting in Puerto Rico. - Background: In 2023, the Maternal, Child, and Adolescent Health Section (MCAHS) of the Puerto Rico Department of Health (PRDOH) applied for the grant (CDC-RFA-DP-23-0066) to enhance the system’s capacity to increase the timeliness, accuracy, and standardization of information available about pregnancy-related deaths, including disparities. Address preventable pregnancy-related deaths and increase the availability of data, including communities disproportionately impacted; and to identify, describe and disseminate information on pregnancy related deaths and opportunities for maternal health promotion and disease prevention. The PRMMRC is developing a systematic process corresponding to the MMRIA system. Purpose: This application will address a major public health problem regarding maternal mortality underreporting in Puerto Rico. Funding will be directed to increase the overall timeliness, factual data which will enhance the PR-MMRC capacity to make recommendations that will address preventable pregnancy-related deaths. The MMRIA/CDC system will allow the PR Department of Health to identify, characterize, and disseminate information on pregnancy related deaths and opportunities for maternal health promotion and disease prevention. Strategies and Activities: The PR-MMRC routinely identifies deaths from death, vital, birth and fetal records of women between 10 and 60 years of all Puerto Rico, regardless of location of death that occur during pregnancy or within one year after the end of pregnancy. The PR-MMRC will continue collaboration efforts with the Demographic Registry Office and NAPHSIS/CDC-STEVE to confirm pregnancy status of potential maternal deaths. Also, has a system for data abstraction and a diverse review committee in professional disciplines and work scenarios with a composition of 13 members selected under Act 186 of 2016. The committee will be selecting recommendations for prioritization and providing potential actions and strategies. Evaluation plan: The surveillance system helps determine the magnitude of maternal deaths, uncovers the details to determine preventable deaths, and provides information to establish prevention mechanisms. The evaluation and performance measurement plan (EPMP) aims for a systematic investigation of the timeliness, accuracy, and standardization of the information obtained through the maternal Mortality Surveillance System in Puerto Rico. It will demonstrate how the surveillance and review efforts have met their objectives and describe what has or has not worked and why. Dissemination: The dissemination of information will be through social media, collaborative SUMMIT (ACOG & Hospitals), continuing medical and nursing education. Also workshops for OB/GYN, Family Medicine, and Emergency Medicine residents; Puerto Rico Department of Health webpage, and annual bulletin. Meetings with representatives of the community, including non-profit organizations, from the different municipalities in Puerto Rico will be performed
