{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T16:59:37Z","timestamp":1765040377865},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,1,4]],"date-time":"2013-01-04T00:00:00Z","timestamp":1357257600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the development of the maternal death surveillance system (<jats:styled-content style=\"fixed-case\">MDSS<\/jats:styled-content>) in Morocco and discuss the initial results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The nationwide <jats:styled-content style=\"fixed-case\">MDSS<\/jats:styled-content> was implemented in 2009 with the involvement of health professionals and local authorities. It comprises (i) notification of all deaths of women of reproductive age (from 15 to 49\u00a0years); (ii) a preliminary survey to identify pregnancy\u2010related deaths; (iii) a confidential enquiry into all pregnancy\u2010related deaths. The information thus obtained describes socio\u2010demographic characteristics of the women, their obstetric and medical history, the mode of delivery, its follow\u2010up and the medical cause of death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 1st of January 2009 to 31st of <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>ecember 2009, 3814 deaths of women of reproductive age were recorded, and a total of 436 pregnancy\u2010related deaths were identified, with 73.4% of those occurring in health facilities. Among the 313 reviewed records, 80.8% were direct obstetric deaths, and 13.5% were classified as indirect. Haemorrhage was the first direct obstetric cause of death (33%). Heart disease was the main indirect obstetric cause of death (39% of indirect causes).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>oroccan <jats:styled-content style=\"fixed-case\">MDSS<\/jats:styled-content> is a powerful tool for understanding the causes and circumstances of maternal deaths. However, challenges remain regarding the full coverage of the system, the decentralisation of the data entry and analysis and the completeness of medical records.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12053","type":"journal-article","created":{"date-parts":[[2013,1,4]],"date-time":"2013-01-04T16:21:28Z","timestamp":1357316488000},"page":"357-365","source":"Crossref","is-referenced-by-count":16,"title":["Implementing a maternal mortality surveillance system in <scp>M<\/scp>orocco \u2013 challenges and opportunities"],"prefix":"10.1111","volume":"18","author":[{"given":"S.","family":"Abouchadi","sequence":"first","affiliation":[{"name":"Ministry of Health Direction des H\u00f4pitaux et des Soins Ambulatoires Rabat Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Belghiti Alaoui","sequence":"additional","affiliation":[{"name":"Ministry of Health Direction des H\u00f4pitaux et des Soins Ambulatoires Rabat Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. 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