ABSTRACT
Background: COVID-19 and associated public health measures in low- and middle-income countries (LMIC) in the Asia Pacific Region have resulted in significant health service disruptions including disruption to MPDSR systems. Reports indicate maternal and perinatal mortality is rising due to both direct and indirect pandemic responses. Methods: We undertook a rapid stocktake process to understand the impact of COVID-19 on service provision and MPDSR. Data were collected by survey of 22 countries utilising a Likert scale measuring respondents' agreement with statements regarding MPDSR practices and health service disruptions. UNFPA representatives in identified countries were responsible for completing the survey. Results: Seventeen of the 22 country surveys were returned. Most frequently reported disruptions to MPDSR systems were lack of completion or delay of death reviews at both facility and country level and decreases in number of community death notifications. Redeployment of both maternity staff and those responsible for MPDSR activities was identified as a key issue. More than half of countries reported that MPDSR key contacts were redeployed to other COVID-19 duties. Countries where MPDSR had been in use for greater than 5 years reported less disruptions. Other COVID-19 related service disruptions included shortages of life-saving drugs, reduced operating theatre availability, and difficulty accessing emergency transport. Conclusions: Countries with embedded MPDSR systems and early prioritisation of maternal and newborn health reported less service disruptions. Urgent investment is needed to strengthen and scale up MPDSR processes to ensure that gains made prepandemic reducing global maternal and newborn deaths will not be lost.