<b>A SYSTEMATIC REVIEW OF THE IMPLEMENTATION AND FUNCTIONALITY OF MPDSR COMMITTEES IN AFRICA</b>

Introduction: Maternal and perinatal death surveillance and response is a key strategy to reduce preventable maternal and newborn deaths. Maternal mortality ratio reflects health system performance and women’s well-being. In 2012, the World Health Organization and partners introduced the Maternal Death Surveillance and Response system to address high MMRs in low- and middle-income African countries. This review evaluates the implementation of the MPDSR committee and its impact on maternal and perinatal outcomes in Africa. Methods: A total of 23 relevant studies published between 2002 and 2025 were identified through a comprehensive search of academic databases using PRISMA criteria and the PICOS framework. The AACODS checklist (authority, accuracy, coverage, objectivity, date, significance) was applied to assess study quality. Results: The review assessed the establishment and functioning of MPDSR committees across African countries. Implementation varied from national systems in South Africa and Ghana to facility-level audits in Nigeria and Kenya. Functional systems were associated with action-oriented responses, structured feedback, and regular evaluations. Challenges included blame culture, underreporting, staffing shortages, poor recordkeeping, and limited community involvement. Despite these barriers, studies have shown that effective MPDSR adoption has led to reduced maternal mortality and improved clinical accountability. Supportive leadership, standardized processes, and a learning-oriented culture were key to success. Conclusion: MPDSR committees are widely implemented in Africa, but structural, cultural, and institutional challenges continue to limit their impact. Countries emphasizing effective responses, regular feedback, and blame-free environments achieve better maternal and perinatal outcomes. Strengthened leadership, enhanced health worker capacity, and community engagement are essential to fully realize the potential of MPDSR systems in reducing preventable deaths