Evaluation of the Maternal Mortality Surveillance System, The Gambia, 2022

Introduction: Surveillance is critical in tracking maternal deaths, particularly in Africa. As a result, we evaluated The Gambia's Maternal Mortality Surveillance System to determine its usefulness and to assess some of its system attributes. Methods: We conducted a cross-sectional study and interviewed stakeholders in the maternal mortality surveillance system in The Gambia. Using a self-administered questionnaire prepared from the CDC updated guideline for surveillance system evaluation, means and standard deviations (SD), frequencies and proportions were calculated. We scored "0" for findings that do not support the attribute assessed and "1" for key findings that support it and were summarized in proportions for scoring. Proportions of responses were scored as good (≥80%), fair (50-79%), and poor (<50%) for each attribute. Results: Of the 25 surveillance officers interviewed, 88% (22) were males, the median age was 37 (IQR 31-40) years, and 52% (13) were between the ages of 31 and 40 years inclusive. Fifty-two per cent (13) had no surveillance training, while 48% (12) were trained in surveillance. The maternal mortality surveillance system was useful (82%), fairly flexible (60%), fairly timely (50%), fairly representative (55%), and fairly stable (68%), but data quality and completeness were poor (37%). Conclusion: The Gambia's maternal death surveillance system was found to be useful. The quality of data and completeness of reporting were poor, while the timeliness, flexibility, and representativeness of the surveillance system need to be improved. We recommend sensitizing health workers on ensuring data quality and completing their reports.